The 24th Issue of the Perkins&Will Research Journal by pw_marketing

Research Journal

2021 ― Volume 13.01

Research Journal 2021 ― Volume 13.01

Editors: Ajla Aksamija, Ph.D., LEED AP® BD+C, CDT Kalpana Kuttaiah, Associate AIA, LEED AP® BD+C Journal Design & Layout: Kalpana Kuttaiah, Associate AIA, LEED AP® BD+C

Acknowledgements: We would like to extend our appreciation to everyone who contributed to the research work and articles published within this journal.

Perkins&Will is an interdisciplinary design practice offering services in the areas of Architecture, Interior Design, Branded Environments, Planning and Strategies, and Urban Design.

Research Journal 2021 ― Volume 13.01

Research Journal

2021 ― Volume 13.01

Journal Overview The Perkin&Will Research Journal documents research relating to the architectural and design practice. Architectural design requires immense amounts of information for inspiration, creation, and construction of buildings. Considerations for sustainability, innovation, and high-performance designs lead the way of our practice where research is an integral part of the process. The themes included in this journal illustrate types of projects and inquiries undertaken at Perkins&Will and capture research questions, methodologies, and results of these inquiries. The Perkins&Will Research Journal is a peer-reviewed research journal dedicated to documenting and presenting practice-related research associated with buildings and their environments. The unique aspect of this journal is that it conveys practice-oriented research aimed at supporting our teams. This is the 24th issue of the Perkins&Will Research Journal. We welcome contributions for future issues. Research is systematic investigation into existing knowledge in order to discover or revise facts or add to knowledge about a certain topic. In architectural design, we take an existing condition and improve upon it with our design solutions. During the design process we constantly gather and evaluate information from different sources and apply it to solve our design problems, thus creating new information and knowledge. An important part of the research process is documentation and communication. We are sharing combined efforts and findings of Perkins&Will researchers and project teams within this journal.

Perkins&Will engages in the following areas of research: ǌ Practice related research ǌ Resilience and sustainable design ǌ Strategies for operational efficiency ǌ Advanced building technology and performance ǌ Design process benchmarking ǌ Carbon and energy analysis ǌ Organizational behavior

Editorial This issue of Perkins&Will Research Journal includes four research articles and a book review. The research articles focus on different research topics, including regenerative design for healthcare, conceptual innovations in healthcare design, innovative approach for designing radiation oncology environments, and the impacts of changing working behaviors during the pandemic on operational carbon. “An Interlace of Regenerative Design in Ambulatory Care: Emerging Practices and Principles of Healthcare Decentralization in Community-Based Design” discusses decentralization of healthcare within the community context and a framework for community-based planning for physical and mental health. The article presents a specific case study, Piedmont Pinewood Wellness Center, and illustrates how the framework was utilized for the design and planning of this facility. “Conceptual Innovations in Healthcare Design: Therapeutic Community as a Translational Laboratory” presents a design exploration, conducted for a specific design competition focusing on the design of a therapeutic community for space travel. The article discusses how translational medicine may drive innovation in healthcare design and presents a conceptual design for an interplanetary vehicle. “Outside the Box: An Innovative Approach to Vault Design and the Evolution of the Radiation Oncology Environment” investigates design strategies for this specialized healthcare environment which enhance the well-being, comfort, and patients’ safety. The article discusses a specific case study, as well as relevant literature. “COVID-19 Response: Impact of Adaptive Working Behavior on Operating Carbon” presents influences of different scenarios of working and commuting behavior on energy consumption and associated carbon emissions. Two case studies are presented, and the analysis shows the implications in changes in behavior and the resulting carbon implications. “Book Review: Research Methods for the Architectural Profession” analyzes a recently published book on architectural research. The review states that the book addresses this important topic with clarity and directness and suggests that it can be used a roadmap for all firms interested in engaging in research.

Ajla Aksamija, PhD, LEED AP® BD+C, CDT Kalpana Kuttaiah, Associate AIA, LEED AP® BD+C

Contents Journal Overview

Editorial

RESEARCH ARTICLES 01: An Interlace of Regenerative Design in Ambulatory Care: Emerging Practices and Principles of Healthcare Decentralization in Community-Based Design

Joshua Robinson, Associate AIA Pegah Zamani, Ph.D.

02: Conceptual Innovations in Healthcare Design: Therapeutic Community as a Translational Laboratory

Julio Brenes Julia Cheung, LEED GA Kalpana Kuttaiah, Associate AIA, LEED AP® BD+C Lauren Neefe, Ph.D.

03: Outside the Box: An Innovative Approach to Vault Design and the Evolution of the Radiation Oncology Environment Sapna Bhat, RA, LEED AP

Justin Parscale, AIA, LEED AP®

04: COVID-19 Response: Impact of Adaptive Working Behavior on Operating Carbon

Roya Rezaee Ph.D., CPHC, LEED AP BD+C ®

Cheney Chen, Ph.D., P. Eng., BEMP, CPHD, LEED AP® BD+C Tyrone Marshall, AIA, NOMA, LEED AP® BD+C John Haymaker, Ph.D., AIA, LEED AP®

PERSPECTIVE 05: BOOK REVIEW: Research Methods for the Architectural Profession

David Green, AIA, LEED AP® BD+C

Peer Reviewers

Authors

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2021 ― Volume 13.01

Research Articles

Research Journal

2021 ― Volume 13.01

An Interlace of Regenerative Design in Ambulatory Care

01 An Interlace of Regenerative Design in Ambulatory Care: Emerging Practices and Principles of Healthcare Decentralization in Community-Based Design Joshua Robinson, Associate AIA, joshua.robinson@perkinswill.com Pegah Zamani, Ph.D., pegah.zamani@gmail.com

Abstract What design strategies should be used for expanding the boundary of healthcare facilities beyond the conventional norm? How could design practice create a facility that is more than a community wellness center? This paper focuses on the expansion and decentralization of healthcare within a community context. For academics and practitioners, the changing landscape of the healthcare system has offered different opportunities within the built environment to enhance the community's well-being. To establish a point of departure, this study employs the methodology developed in an earlier collaborative academic research based on a series of in-depth and systematic precedents study to investigate and identify the embedded spatial principles underlying social characteristics of a set of selected healthcare cases, generating a repertoire. As a result of this research, design patterns were created to develop a program framework through three lenses of focus: Patterns of Biophilic Design, WELL Building Standard®, and Community-based Design. The methodology extracted from the case studies analysis is mapped into analyzing Piedmont Pinewood Wellness Center. This case study has been selected because of its intent to invest communitybased wellness globally by a healthcare system, which offers an inspiration resource related to redefining programs within a medical facility. Its community is addressed via non-medical determinants. The finding unfolds how a facility could holistically operate as a place for the physical, mental health of the individuals and the well-being of the community. Keywords: non-medical determinants, regenerative design, community-based health design, patterns of biophilic design, WELL Building Standard®

1.0 Introduction This study inquires how the standard healthcare typology can be reshaped to address medical, mental health, and community needs. The healthcare system in the United States is complicated due to many factors, including access to medical services and insurance. Within this context, the decentralization of our medical institutions can offer alternatives to the convoluted healthcare system by giving consumers more options and better care. A CVS Health study found that 72% of Americans believe that the U.S. health care system does

not work for them1. What is even more appalling is that 23% of Americans say their health care has gotten worse. This study seeks to outline an architectural framework for wellness, prevention, and early detection to confront these alarming concerns for developing a more holistic healthcare narrative. Within its theoretical and methodological line of inquiry, the research examines integrating regenerative design into healthcare facilities to recreate public spaces and standardize well-being at individual and community levels.

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As a case study, the Piedmont Pinewood Wellness Center is reviewed through the design parameters of three lenses: the Patterns of Biophilic Design focused on building human connections with nature through design by William Browning and Catherine Ryan of Terrapin Bright Green; the Wellness Patterns based on the WELL Building Standard®; and lastly, the Community Patterns concentrated on creating walkable living spaces. The article serves as a bridge between earlier academic research and a built project to stimulate restructuring the design process for a more efficient health care service and access.

to Regenerative Design within the healthcare industry, as previously mentioned by Guenther. This can be traced in a few hospital systems. Within New York state hospitals, as a case, “some hospitals have developed programs addressing non-medical health determinantssuch as access to healthy foods and parks, housing, and employment-by partnering with community organizations and local government. These programs require relatively little investment; they leverage the hospital’s key role and relationships in the community to catalyze change”⁴. Non-medical determinants positively impact the overall community, but they benefit from boosting social interaction through various levels of engagement. Valuing non-medical determinants can help optimize urban planning and building healthier communities.

1.1 Literature Review We focus on the whole systems approach to study the wellbeing design standards for a deeper understanding of the current healthcare industry. To address the impacts of the built environment on public health, the study expands the focus from the resilient regenerative design for creating sustainable built environments, emphasizing Biophilic Design Patterns and WELL Building Standard®. Guenther argues that "architecture for health is about more than curing human illness. It is also about regenerative design, where buildings become net resource generators rather than resource consumers, and where initiatives are established to prevent the causes of epidemics"². Guenther's work led us to look deeply at social interaction in public spaces and the needs of communities regarding healthcare. To focus on regenerative design within public health, non-medical determinants expand the boundaries of a conventional healthcare setting by offering a new lens that investigates the connections to communities. While this is not a new concept to the health system, it has not been applied and implemented system-wide, hence our inquiry into biophilic, wellness, and communitybased design and their possible impacts on the built environment.

Further rectifying improper land use by utilizing nonmedical determinants will allow for better health care outcomes. Chen et al. state, “there are multiple health determinants other than medical care, including social factors such as education, poverty, inequality, and the built environment. While it has been estimated that only 10% of the health determinants can be attributed to clinical care, 40% has been attributed to social and economic factors, 30% to health behaviors, and 10% to environmental factors”⁴.

1.1.2 Building Restorative Healthcare Restorative healthcare focuses on medical centers delivering positive outcomes for individuals and communities. Guenther addresses the state of health care architecture by asking: “Can traditional healthcare organizations be leveraged to catalyze transformation within their walls and in their communities to bend the chronic disease curve, fundamentally reducing the environmental, social, and economic causation of asthma, obesity, and diabetes?”². Guenther makes the case that medical facilities should be able to do more for the communities they serve. The author believes that the healthcare industry is at a significant turning point; the transition will be from green design and high performance to regenerative design and healing buildings. Guenther states that “the healthcare industry is in a pivotal position to lead a reintegration of social, economic, environmental, health, and resource balanced sustainable practices of restoration and

1.1.1 Non-Medical Determinants Non-medical determinants are defined as “those that fall outside the sphere of medical/health care, generally speaking, but that has been shown to affect health status and, in some cases, access to health services.”³. Non-medical determinants can be a means

An Interlace of Regenerative Design in Ambulatory Care

healing. The sector can move beyond a focus on doing ‘less harm’ to a future that positively contributes to the conditions that foster individual, community, and global health“2. Taking a restorative approach to health care will transition medical facilities from only doing less harm to providing concrete benefits to the communities these facilities serve.

wellness that hit on many of the same points as Dunn but provided additional details. He argued that wellness is "self-responsibility, nutritional awareness, physical fitness, stress, and environmental sensitivity"⁸. Today, the WELL Building Standard® is the guideline and tool for measuring wellness in the built environments. The WELL Standard integrated best practices in design and constructions with evidence-based health and wellness interventions. It promotes human health, well-being, and comfort in the built environment. Thus, implementing strategies, programs, and technologies designed to encourage healthy, more active lifestyles and reducing occupant exposure to harmful chemicals and pollutants is the primary objective of this standard9. The wellness standards within the Building WELL Standard stress qualities such as Air, Fitness, Water, Comfort, Nourishment, Mind, and Light.

1.1.3. Biophilic Design Patterns Patterns of Biophilic Design offer pragmatic applied performative criteria to measure place-making and built environment projects in creating healthy places for humans and living systems⁵ Wilson first popularized the term biophilia in his book Biophilia⁶ Wilson proposed that the “tendency of humans to focus on and to affiliate with nature and other life forms have, in part, a genetic basis”⁵. Since Wilson introduced it, the term has been used in various settings and forums depending on the field of study being discussed.

1.1.5. Determinant Community Social Interaction In professional practice, community designers recognize and resolve specific issues that link social, economic, or political aspects of a community10. Understanding how community functions and activates their urban space is key to improving social interaction for all involved. At the same time, a framework of non-medical determinants must be created to usher in restorative health care. Nonmedical determinants play a crucial role because they rely on community engagement and a diverse number of organizations. An emphasis on cultural identity will advance healthcare design closer to bringing about positive results for individuals and communities. Collier and Thomas have theorized the properties of cultural identity by merging communication and social construction ethnography11. To Collier, cultural identity is self-identification, a sense of belonging “to a particular way of living, including language, religion, art, food, values, traditions, or any other day-to-day practice; associated with the historical experience of a particular group of people”12. All these factors must be maintained and even enhanced to improve communities.

It was not until 2014 that biophilia in architecture was standardized. Browning, Clancy, and Ryan define biophilia simply as “humankind’s innate biological connection to nature”⁵. Similar to the Building WELL Standard, biophilia also has measures that are configured into three larger groups. “Nature in the Space addresses the direct, physical, and ephemeral presence of nature in a space or place which includes plant life, water and animals, as well as breezes, sounds, scents, and other natural elements”⁵.

1.1.4. WELL Building Standard® Dunn is noted as the father of wellness. His paper 'High-Level Wellness for Man & Society'—published in 1959—established the foundation for a more inclusive and innovative approach to healthcare. Dunn argued for healthcare as more than the mere absence of disease; he defined wellness as "an integrated method of functioning, which is oriented towards maximizing the potential of which the individual is capable"⁷ This mode of thinking provided a lasting effect on the healthcare industry. It restructured patient care by establishing personal responsibility as well as correct practices and attitudes. Since 1959, there have been numerous attempts to redefine and reevaluate wellness as a broader concept. Ardell formulated a definition of

Community patterns explore how people are connected to the area and environment around them. The community patterns focus on Walkability + Connectivity, Quality of Life, and Quality of Design. Specifically, creating walkable spaces is important in community design. Creating a walkable community allows residents

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to have greater access to their local facilities and places of business.

2.0 Design Framework and Methodology

Additionally, walkable spaces creates opportunities for residents to interact with others to develop healthy relationships. Streets should be designed in a pedestrian-friendly way to facilitate walking and bike riding. An ideal urban space would have many mixed-use facilities. This creates diversity in all life facets; residents would be near individuals of different backgrounds, socioeconomic status, and cultures. A community designed in this way provides benefits to the residents, businesses, developers, and the local government. A walking-friendly urbanscape will allow people greater access to businesses, shops, and restaurants. Developers would benefit due to a proliferation of mixed-use projects in the area, which can increase property values. Municipalities will benefit from cost savings; there would be less use of roads, improved health of residents, and a healthy and vibrant overall community. This community would emphasize aesthetics and ample green space so that residents can maintain a healthy lifestyle in their day-to-day lives

Architectural researchers and practitioners have often relied on qualitative research methods applicable to the architectural profession and academia. Qualitative methods employ non-numerical strategies such as case study research to investigate research questions13. Case study research, as a strategy of inquiry, has been utilized for this research methodology. The study reports on a qualitative method for analyzing the built environment applied previously in an academic setting for a comparative morphological evaluation of selected case studies across the world on a wide array of climate zones. Within the cases’ analysis, a qualitative inquiry of defined standards was explored to understand each case in-depth in its context. The design patterns combine the research results authors accumulated in earlier collaborative research at the Eco-Morphology Lab focused on three core areas as drivers to influence the design process: Patterns of Biophilic Design, WELL Building Standard®, and Community-based Design. The research investigated a series of analytical case studies and precedents parallel to the theoretical literature resulting in overlapping design standards and patterns to advance wellbeing and community connectivity, as shown in Figure 1.

An Interlace of Regenerative Design in Ambulatory Care

Figure 1: A brief selection of cases from the comparative analysis and qualitative research conducted at the Eco-Morphology Lab

3.0 Research Case Study

235-acre master-planned residential and mixed-use development, is about 30 minutes south of downtown Atlanta. The walkable town was designed with several green features as the country’s first geothermal and solar energy-powered micro-home village.

Prominent for its medical care, Piedmont Healthcare has recognized the critical role of prevention and invests profoundly in the notion of wellness in the community. Their Fayetteville, Georgia facility, known as Piedmont Wellness Center, has been selected as an intriguing case for this study. Opened in October 2019, the twostory facility offers more than 60,000 square feet for containing functional fitness spaces and healthcare spaces for medical professionals. As a medically integrated wellness center, the center intertwines the Piedmont Fayette Hospital, Pace Lynch Corporation, and Pinewood Forest area. Pinewood Forest, a

3.1. Biophilic Design Patterns Through the lens of Biophilia patterns, a review of the Piedmont Wellness Center highlights human connections with nature on multiple levels, as shown in Figure 2. There is a clear focus on material, biophilic form and visual connection with nature. In the Center, the active spaces

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01. Abstracted tree limbs served as the muse for the design of feature wall graphics.

02. It blends different materials to create pops of colors that brand the clients' message and showcases the community-the wall serves as a wayfinding element throughout the building.

03. The community stairs blend materiality, cross-function, views, and daylight into one node.

Figure 2: Through the lens of the biophilic design patterns.

are oriented to provide a constant visual connection to nature with maximum transparency. The design team incorporated boot camp-style workout areas with floorto-ceiling doors that open during more excellent weather. There is a constant emphasis on views of nature and the transition between exterior and interior space. The building layout and facades enrich multiple patterns of visibility and accessibility across interior/exterior boundaries, as presented in Figure 4.

Structural wood decking is utilized in critical areas to further that connection to the surrounding environment, while environmental graphics blend the mission of Piedmont Healthcare with natural visual forms. Beyond the building, the facility users will be able to take advantage of activity lawns and miles of trails being developed as part of the community. Hiking trails run through a grove of trees just beyond the building’s footprint. Walkers will find art installations along the way to promote visual therapybased psychological and physiological healing

An Interlace of Regenerative Design in Ambulatory Care

01. Within the nested breakout spaces, the corridor has seating along the exterior glass to connect with the grove. 02. The physical therapy gym has natural daylight and views of the groves. The use of interior glass intentionally created a sense of transparency between the inhabitance and the therapist. 03. The natatorium has both views of the surrounding nature and warm wood tones in the ceiling, absorbing sound and creating visuals cues for the swimmers.

Figure 3: Through the lens of the biophilic wellness patterns.

3.2. Wellness Patterns

The graphic art on the primary diagram connection within the building supports the standards of wellness. Branding and visioning, based on clients’ vision and mission, introduced the 10 dimensions of wellness: physical, emotional, spiritual, career, intellectual, environmental, social, mind, community, and innovation. The ideas are represented as photos and patterning on the walls that serve as a spine that connects the entry and classrooms to the therapy and lane pool at the

This facility provides patient-centered care where convenience, care, preventive methods, and programs are significant factors. Having an exam and walking 20 feet to the pool, spa, or yoga makes healing easy and enjoyable. There is an importance placed on preventive care at Piedmont, thus creating a path for clinical spaces to be nestled into the center’s program.

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furthest end of the building—reminding the inhabitants that surrounding the environment and personal efforts play into their wellness. The swimming area contains a therapy pool and a lane pool with direct views of nature and daylight, as presented in Figure 3.

boxing, etc.); full-service locker rooms; upscale cardio, functional training, and resistance equipment; aquatics area with 6-lane lap pool and warm water therapy pool; immersive bicycle experience; heart-rate based group training areas; and a human performance area. While the facility acts as a place for holistic physical and mental health and well-being, education is at the root of Piedmont’s wellness philosophy. Test kitchens promote nutrition, and classrooms allow for meditative teachings.

Using passive and active sustainable design strategies, the building’s placement alongside a grove of oldgrowth trees provides shade in the summer while exterior green screens reduce solar heat gain. The design team has utilized research knowledge and environmental understanding to support design ideas such as daylighting and access to fresh air flow. Education is woven into care and the idea of a sense of joy in a daily routine

The Wellness Center engages with the outdoors outside a wall of glass, connecting with a central park, an openair elevated exercise platform, activity lawns, and more than 15 miles of integrated trail and path systems that meander throughout the mixed-use neighborhood community and nature preserve areas. Access to community and clarity of wayfinding has been ranked walk scores of above 80 by Active Design.

3.3. Community-Based Design Patterns The Pinewood Forest residential and commercial development is situated on 234 acres, including mixeduse retail, office/commercial/retail, hotel rooms, multi-family, live-work units, townhome units, and single-family residences. The Wellness Center was in large part designed to service this rapidly growing community and movie industry types alike. The facility is part of the “new urbanist” Pinewood Forest community which includes miles of nature/walking trails. The design seeks to heighten the idea of communal wellness by strengthening the connection between people and nature while bringing the community together in a simplified building form, which is situated adjacent to the distinguishing natural feature of Pinewood Forest known as The Grove, as shown in Figure 4.

3.4. Design Patterns Overlay: Evidence-Based Design (EBD) A significant component of the project concept was based on Evidence-Based Design (EBD) research. It stemmed from an extensive review of biological and behavioral responses within the practice of EBD. The project design team utilized findings to support design moves and actions such as daylight and circadian light, views to daylight and nature, and the connections to walking paths through the local community. The exterior becomes an extension of the building, displaying biophilic design patterns. Simultaneously, the distinctive branding elements and materiality of main nodes in the Center highlight wellness patterns. Finally, the projects' location, overall massing, and programmatic breakdown demonstrate the community patterns.

In the center, hundreds of different wellness programs and exercise equipment are available to the community and Piedmont patients. The 54,000 square foot medically integrated health and fitness centers are composed of the following features: 1,300 square feet of outdoor exercise area; child care, massage therapy and personal training; group exercise studios (including aerial yoga,

Within the intersection of health and wellness, the facility provides patient-centered care where convenience, care, and preventive methods and programs are promoted to help set this project apart.

An Interlace of Regenerative Design in Ambulatory Care

01 + 02. The centers massing and placement were designed to engage the community. For example, many walking trials terminate or run parallel to the building facade, thus creating moments for the community to engage with the center.

Figure 4: Through the lens of the Community-Based Design Patterns.

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4.0 Conclusion

[2] Guenther, R., (2017). “Transforming Hospitals: Building Restorative Healthcare”, Architectural Design, Vol. 87, No. 2, pp. 128-133.

Academics and practitioners have offered sustainable design strategies, standards, and tools for advancing well-being throughout the built environment design, research, and practice over the past decades. Integrating research into the design practice, this study applied a qualitative methodology to investigate emerging practices and principles in community-based design and wellness. Using the three design patterns, a framework was developed to contextualize the case of the Piedmont Pinewood Wellness Center facility, which serves patients, clinicians, and communities. In doing so, the Center holds the potential to holistically set new programs and blend medical spaces with community spaces. A post-occupancy review will be conducted three years following the building's full operational use to seek users and community feedback. Based on the review result, we will deepen our study to test the research outcome and relevance for future projects underlining how design could interlace medical care and community wellness.

[3] Australian Government, (2016). “Non-Medical Determinants of Health”, Report, Retrieved on 10/2018 from https://meteor.aihw.gov.au/content/index.phtml/ itemId/392618. [4] Chen, M., Unruh, M., Pesko, M., Jung, H-Y., Miranda, Y., Cea, M., Garcel, J., and Casalino, L., (2016). The Role of Hospitals in Improving Non-Medical Determinants of Community Population Health, Ithaca, NY: Weill Cornell Medical College.[04] [5] Browning, W., Ryan, C., and Clancy, J., (2014). “14 Patterns of Biophilic Design: Improving Health and WellBeing in the Built Environment”, New York, NY: Terrapin Bright Green. [6] Wilson, E., (1984). Biophilia, Cambridge, MA; Harvard University Press. [7] Dunn,H., (1959). “High-Level Wellness for Man and Society”, Philadelphia, PA: J Natl Med Assoc. [8] Ardell, D., (1982). “Planning for wellness: A guidebook for achieving optimal health”, Dubuque, IA: Kendall/Hunt.

Acknowledgments

[9] Carney, R., (2017). The Seven Concepts of the WELL Building Standard-Facilities Management Insights, New York, NY: Delos Living LLC.

The authors would like to thank Amy Sticker, Heidi Steinemann, Jeff Chermely, Marco Nicotera, Richard Herring, and the rest of the Perkins&Will Pinewood Piedmont Wellness Center design team, as well as Piedmont Health Care for allowing us to write this paper. A special thanks to Kalpana Kuttaiah at Perkins&Will, who significantly contributed to the initiatives that have paved the way to advance connecting practitioners to academic researchers.

[10] Comerio, M., (1984). “Community Design: Idealism and Entrepreneurship”, The Journal of Architecture and Planning Research, Vol. 1, No. 1, pp. 227-243. [11] Collier, M., and Thomas, M., (1988). “Cultural Identity - An Interpretive Perspective”, in Theories in Intercultural Communication, Kim, Y., and Gudykunst, W., eds., Thousand Oaks, CA: Sage Publications. [12] Asadollahi, A., Mamaghani, N., and Mortezaei, S., (2015). “Designing for Improving Social Relationship with Interaction Design Approach”, Procedia - Social and Behavioral Sciences, Vol. 201, pp. 377–385.

References [1] Davis, K., (2017). “The State of Healthcare in the United States”, Report, Retrieved on 08/2018 from https:// cvshealth.com/sites/default/files/cvs-health-state-ofhealthcare-in-the-united-states-report.pdf.

[13] Aksamija, A., (2021). Research Methods for the Architectural Profession, New York, NY: Routledge.

Conceptual Innovations in Healthcare Design

02 Conceptual Innovations in Healthcare Design: Therapeutic Community as a Translational Laboratory Julio Brenes, julio.brenes@perkinswill.com Julia Cheung, LEED GA, julia.cheung@perkinswill.com Kalpana Kuttaiah, Associate AIA, LEED AP® BD+C, kalpana.kuttaiah@perkinswill.com Lauren Neefe, Ph.D., lauren.neefe@perkinswill.com

Abstract This investigation was conducted for a conceptual design competition, specifically focusing on the design of a therapeutic community for space travel. The competition encouraged innovation by asking participants to solve challenges anticipated in the future delivery of healthcare without the usual restrictions tied to budget, schedule, and codes. This research focused on Translational Medicine, or “bench to bedside,” which is an important frontier in healthcare applications. This approach in medicine relies on the use of new knowledge obtained in clinical practice to scientific research in the laboratory. The research raised questions about how Translational Medicine might drive innovation in healthcare design, especially with respect to emotional well-being and behavioral health. If we conceived a research and healthcare environment as a “therapeutic community,” how would this approach impact the program and spatial adjacencies? What if the community lived where it conducts its research? How might the spaces be designed to allow for resilience in response to “disturbances” in the community, be they biological (e.g., outbreak), social (e.g., conflict), or behavioral (e.g., depression)? Our research drew knowledge from literature reviews, interviews with healthcare experts on best practices in behavioral health design, research on viral behavior and human health in space flight; and principles of lab productivity and biophilic design. We ultimately applied our research to the conceptual design of an interplanetary vehicle, Vooster Lab, intended to host a “therapeutic community” for the three-year trip to Mars in 2035. Keywords: translational medicine, healthcare design, wellness environments, innovation, behavioral health, interdisciplinary program

1.0 Introduction The healthcare industry is complex and complicated. Between regulations in policy, codes and standards, healthcare reimbursements, clinical applications, operations and delivery to research and discovery, technical advancements for treatment and much more, it can all be overwhelming to comprehend. But, as all of this advances at such a rapid pace, Healthcare Design magazine framed the following questions in the form of a conceptual design competition called Breaking Through:

1) what are the frontiers of healthcare innovation, and 2) where do scientific innovations intersect with innovation in healthcare design? As our own planet becomes more hostile to human life and interplanetary migration becomes more probable, our team decided to investigate the healthcare design applications of extraordinary environments. Translational medicine—that is, the “translation” of laboratory, clinical, or population research into

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implementable clinical tools to improve health outcomes—provided the most powerful and provocative avenue for thinking through the possibilities of a cohesive organization of spaces. When we discovered early in our research that viruses can be reawakened in space flight, changing their behavior, as humans do, under duress, we found the driver for designing a program where viral and human responses to stress could be observed and treated in a single dynamic environment. As we researched further, the initial impetus to take make the interplanetary vessel an experiment extended the meaning of translational medicine into a program where collection, study, collaboration, education, personal health, social activity, collective endeavor, and communal safety can take place in the absence of the crucial sensory aspects of human need.1

considerations (4) for translational research. American astronaut Scott Kelly’s autobiographical testimony about enduring and recovering from his extended space flight (11 months) informed our research into artificial gravity and cosmic-radiation shields. Studying the regenerative support systems on the International Space Station guided our research into producing water and oxygen through Sebatier reactors and electrolysis. NASA documentation of Scott Kelly’s experience and conditions on the International Space Station led us into the potential applications for behavioral health on Earth of behavioral health under the hostile conditions of space flight. We consulted designers with expertise in behavioral health facilities about how the architecture supports reintegration into social settings and looked at strategies employed by innovative facilities such as the Behavioral Sciences Center in Houston. Once the decision was made to create three kinds of environments and separate the living and research environments, we drew on the work of NASA’s Translational Research Institute for Space Health (TRISH) to understand how the application of scientific findings in the Testing (research) Environment to the Sensory (living) Environment as well as institutions and facilities on Earth.

2.0 Conceptual Approach and Literature Review For this conceptual design competition, the team started with brainstorming possible ideas to explore and investigate. Of the many ideas discussed, we narrowed down our investigation to two scenarios that respond to extreme conditions: 1) diagnostic and treatment environments under global-pandemic social constraints, and 2) the simultaneous study of human and viral behavior under extreme stress. We then committed to researching and developing the conceptual design of a small-team research environment for the second scenario. We could simulate physical and emotional distress through selective sensory deprivation in a Rubik’s Cube–like revolving configuration of program and plan. Human and viral response to these extreme conditions could then be observed and adaptive behaviors tested.

We had launched our design process by allowing the limited space and scale considerations to drive the research. However, our research into behavioral health environments quickly led us to shift our drivers from design constraints to the health impacts of program and plan configuration. Our interviews with healthcare experts led us to reconsider the scale of our proposed environment, especially how the scale reflects the relationship between individual well-being and collective adaptation. Our approach applied innovative principles in lab productivity and biophilic design to pivotal considerations for behavioral health environments to achieve the benefits of a “therapeutic community” under conditions of extreme duress.

We conducted an extensive literature review, performed interviews with health experts in the behavioral health field, and considered design scenarios that would inform the program for the conceptual design of an interplanetary vehicle, Vooster Lab, intended to host a “therapeutic community.” Our research followed four lines of inquiry as the design developed: the physiological (1) and mental (2) health hazards of space flight, the technology for generating resources (3) to support Earthnative organisms in space, and the lab and workplace

3.0 Addressing the Conceptual Design Challenge The competition required us to address the specific challenges anticipated in the future delivery of healthcare, who would be affected, what will emerge in

Conceptual Innovations in Healthcare Design

future healthcare environments, and why there is a need to explore new opportunities.

The designs of interplanetary vessels need to be as adaptable and resilient as the environments we are only now beginning to design for climate change and global health emergencies on Earth. When they are, they will provide testing grounds for the healthcare advances needed for life on other planets, life in space, and the life that continues on our planet of origin.

Research into this subject led the team to believe that interplanetary migration is no longer a far-fetched fantasy. It is increasingly within the realm of probability. New environments, in the form of other planets as well as the vessels that transport humans between planets, will necessarily introduce new pathogens. They will also cause existing pathogens to behave differently. Similarly, these new environments will elicit new behavioral and mental-health phenomena.

4.0 Vooster Lab: Studying Humans and Viruses in Spaceflight

Scientists and health researchers need to be able to conduct studies and experiments in situ outside Earth’s atmosphere on the factors that affect human health outside Earth’s atmosphere. Until human life on another planet is a sustained reality, that built environment will to a large extent be the space shuttles and stations that transport humans to and from Earth. Existing shuttle and station design has limited capacity to grow and manipulate organic matter, much less the most swiftly moving targets of study (e.g., viruses and mental health). In addition, its utilitarian focus—however sophisticated and efficient relative to function—deprives humans of the sensory stimuli they need for psychological well-being.

Our Breaking Through entry considered NASA’s plans for a 3-year trip to Mars by 2035 and created a concept for an interplanetary vessel for the joint study of highly mutable disease and psychological resilience on a mission that nearly triples the longest flight any human has made to date.² The Vooster Lab concept was initially envisioned as a revolving configuration of plan and program to support a handful of “Environeers” as they make scientific observations and are themselves subject to observation while living in an environment largely absent the sensory aspects of human need.

Vooster Lab is designed to study human and viral behavior in space. Physical Risks Gravity Fields

Radiation

Loss of Bone Density and Muscle, Adverse Blood Flow

Cancer

*NASA Human Research Program’s “5 Hazards of Space Flight”

Mental Health Risks

Interplanetary Travel

Distance

Isolation

Scarcity of Energy, Oxygen, Water

Low Productivity, Mood Swings, Depression

Confinement Low Morale, Sleep Disorder, Diminished Communication

Length of Flight

Physiological and Psychological Stress

Human Disturbance

Viral Disturbance

Figure 1: Understanding viral and human behavior in response to stress in interplanetary travel.

Perkins&Will

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Because viruses, like humans, alter their behavior under extreme and prolonged stress, the combination of viruses and humans suggested itself as a specific application for Vooster Lab.3 The intent was three-fold: 1) to discover extraterrestrial viruses and mental-health phenomena; 2) to understand the impact of space travel on viruses and disorders that originate on Earth; and 3) to pursue applications of psychological resilience in space for the treatment of trauma and stress on Earth.

isolation is the sense of belonging to a community and the sense of greater purpose that comes with community identification.4 With these correctives in mind, we began to reconceive our experimental Rubik’s Cube environment as a series of environments where a “therapeutic community” of people can form through participation as both investigators and subjects in scientific study. NASA’s Translational Research Institute for Space Health already recognizes that space exploration has relevant impacts for health on Earth. Our Vooster Lab concept intended to make the case that building a therapeutic community as a translation research laboratory for space exploration has relevant impacts for healthcare on Earth as well.

From our interviews and literature reviews, we redirected our conceptual design to address two considerations. First, a psychological or emotional disturbance is better healed by integration in social settings rather than by confinement in the typical hospital room. Second, a potent countermeasure for the sensory deprivations of

Three concentric rings host a self- sustaining community of high- functioning, highly trained people under extreme conditions.

Sensory Environment

A single ring of research, collaboration, and communication modules hosts on-site and interplanetary investigation and education.

Testing Environment

Strategic recovery zones host the observation and resolution of outbreaks of disease or psychological symptoms.

Disturbance Environment

Figure 2: A system of three community-oriented environments anchored by an axial spine of core functions make up the Vooster Lab.

Conceptual Innovations in Healthcare Design

5.0 Therapeutic Community: A System of Three Environments for Translational Research

Using space flight as the most extreme case of a hostile yet livable environment, we used the “5 Hazards of Space Flight” identified by NASA’s Human Research Program and Translational Research Institute for Space Health to guide the Sensory Environment’s program.5 Integrating countermeasures to the physical and psychological risks of austere conditions, the Sensory Environment is a kind of “live” and ”play” network of spaces: it balances privacy with social settings and opportunities for movement and activity with access to organic forms and restorative settings. Specially treated glass cladding simulates circadian rhythms of daylight to help regulate the Environeers biological clock and support their psychological and physiological adaptation to spaceflight.6

To conduct translational research on behavioral health under the stress of considerable sensory deprivation, we tailored our design to the health benefits of belonging and greater purpose. Our concept for a “therapeutic community” is an integrated system of three environments that supports holistic wellness under sensory deprivation while investigating human adaptation and specimen behavior and testing treatment options. Sensory and Testing Environments are coordinated programs of adjacencies, while the Disturbance Environment is a flexible typology dispersed cellularly throughout the system.

Wellness Ring Gravitational Therapy Social and Physical Simulation Biophilia Ring Organic Farm Connection to Nature

Privacy Ring Circadian Glass Sleep and Relaxation

Figure 3: The Sensory Environments of the Vooster Lab.

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Laboratories Virology Mutation and Reawakening Observation Decontamination and Containment

Radiation Irradiation for Zero-Gravity Cloning Heavy Ion Harvesting for Cancer Treatment

Zero Gravity Bacteria Mutation Organic Material Cloning

Deep Space Forum and Translational Reseaarch Interplanetary Investigation and Teaching Vooster Community Health Assesment

Mars Exploration Deployable Exploration Labs Specimen Collection

Figure 4: The Testing Environment of the Vooster Lab.

Theraputic Cell for the resolution of individual disturbance

Meditation Cell for the resolution of social disturbance

The Vooster Lab design tests the potential of Transational Medicine because Environeers are at once investigators and subjects in their therapeutic research community.

Containment Cell for the resolution of pathalogical disturbance

Figure 5: The Disturbance Environments where Environeers are subjects of the Vooster Lab.

Conceptual Innovations in Healthcare Design

The Testing Environment uses principles of passive contact and strategic adjacencies to spur creativity and productivity in the laboratory and research, or “work” program.7 The therapeutic community is an interdisciplinary community, so the network of collaboration and “collision” spaces will support a collective sense of purpose around research and education.

the observation, testing, and resolution of disease or psychological disturbance, i.e., symptoms. A Therapeutic Zone resolves individual disturbance, a Mediation Zone resolves social disturbance, and a Containment Zone resolves pathogenic disturbance. In this respect, designing the built environment for a therapeutic community pushes the frontier of translational medicine by making community members at once the investigators and the subjects in the community’s research enterprise.

A typology more than a distinct program, the Disturbance Environments consist of recovery zones for

Figure 6: Inside the Sensory Environment.

Figure 7: Inside the Testing Environment.

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6.0 The Support Systems Strategy The Vooster Lab design supports a therapeutic community studying human and viral behavior by integrating the Sensory, Testing, and Disturbance Environments along an axial circulation and systems spine. While behavioral health models and translational research needs guided the program, adjacencies, and circulation of the Environments, maximizing safety, resources, and opportunities for research in space determined the form and function of the vessel’s shell. The deployable labs, for example, have the capacity to harvest ice from Mars to support the reactors that recycle oxygen into air and water, but they also assist with correcting the vessel’s trajectory when in orbit around Mars. In the future, these independent vessels can transport specialized experts to assist the Environeers who will eventually inhabit Mars. The ring design performs multiple support functions as well. The concentric rings of the Sensory Environment revolve around the axial spine to create artificial gravity on an adjustable gradient, which helps the human body

Figure 8: Inside the Disturbance Environment.

Pressurized modules are protected from cosmic radiation by an interwall layer of ice and electromagnetic fields generated by the rings.

Figure 9: Radiation protection strategy.

Conceptual Innovations in Healthcare Design

Thermal control on the "dark side"

Denotes photovoltaic panels toward the "bright side" (i.e. sun)

Figure 10: Solar energy strategy for the Vooster Lab.

Biophilia Ring’s Drum

Sebatier Reactor [Recover water from Co2 and H in electrolysis] Organic waste microbial reactor [recycle]

Deployable sail to harvest heavy ions/cosmic rays

Electrolysis [generate oxygen from H20] Able to havrvest Ice from Mars [supports O and H20 generator systems]

Spare Modules

Repair Bots Module

Thermal Control Removal

Navigation controls

Additional energy module/ part of Cosmic Rays system Engines

Radiation Lab Propellant Tanks

Airlock

Sebatier Reactor Lab

Spare Parts Module

Denotes Circulation

Battery

Circadian glass tecnology to improve routines / photovoltaic cells

Figure 11: The support systems strategy for the Vooster Lab.

Linear propellants from Deployable Labs assist to correct vessel trajectory

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7.0 Conclusion

and brain adapt to variable gravitational fields between Earth and Mars. 8 In combination with the Testing Environment ring at the other pole of the spine, the Sensory Environment rings generate an electromagnetic field that, in combination with an interwall layer of ice, protect the pressurized modules from cosmic radiation.9 Photovoltaic panels attached to the rings generate all the energy required for the vessel’s systems to function.

Vooster Lab’s design answers a dynamic yet integrated plan for three environments supporting translation research during extended spaceflight. The Testing Environment resembles a conventional laboratory, outfitting experiments with specimens collected in space or on Earth, including dormant viruses that may awaken once a body leaves Earth’s atmosphere. The Disturbance Environment is maximally flexible. Featuring a porthole view into outer space, it is programmed to observe and resolve the outbreak of disease, psychological, or social symptoms. The Sensory Environment is the most ambitious. Three concentric rings create a gradient of artificial gravity and host a self-sustaining community of high-functioning, highly trained people under extreme conditions.

To further ground our concept in the engineering reality of spaceflight, we researched the complex support systems that would need to operate within the axial spine. In addition to engines, batteries, propellant tanks, and navigation controls, the spine houses a variety of reactors to recycle waste molecules into air and water. The spine also houses deployable sails that can harvest cosmic radiation and heavy ions for testing within the vessel’s laboratories or back on Earth.10 Repair bots are available to assist the aerospace engineers onboard.11

Figure 12: A conceptual rendering of the Vooster Lab.

Conceptual Innovations in Healthcare Design

While Vooster Lab is without question a conceptual flight of fancy, its design innovations are twofold. The thorough integration of support systems and research technologies, synergy-promoting adjacencies, varied but coordinated social and wellness programs, and experimentation environments is a conceptual feat. The second, more significant innovation of Vooster Lab is the convergence of space flight technology, behavioral health programming, and translational research in the concept of a “therapeutic community.” It imagines how the unique experiment that is any given space flight must scale up as interplanetary travel becomes a reality, but it also models an approach to the social character of highly programmed clinical and research environments, where it is imperative that the design negotiate and support the resilience of the individual, the collective endeavor, and the greater environment.

[4] Davis, D., (2020). Interview by Julio Brenes and Kalpana Kuttaiah. Microsoft Teams. 40 minutes. [5] Human Research Program (HRP), (2021). “5 Hazards of Human Spaceflight”, Retrieved on 4/5/21 from https:// www.nasa.gov/hrp/5-hazards-of-human-spaceflight. [6] Malone, A., (2018). “Circadian Curtain Wall by HOK Is a Curved Glass Façade that Responds to the Sun’s Path”, Designboom, Retrieved on 4/13/21 from https://www. designboom.com/design/circadian-curtain-wall-hokcurverd-glass-facade-05-23-2018/. [7] Miller, D., (2020). “Designing Labs for Productivity.” Lab Manager, Retrieved on 4/5/21 from https:// www.labmanager.com/lab-design-and-furnishings/ designing-labs-for-productivity-21871. [8] Clement, G., Bukley, A., and Paloski, W., (2015). “Artificial Gravity as a Countermeasure for Mitigating Physiological Deconditioning During Long-Duration Space Missions”. Frontiers in Systems Neuroscience, https://doi.org/10.3389/fnsys.2015.00092.

Acknowledgments

[9] van Ellen, L., and Peck, D., (2018). “Use of In Situ Ice to Build a Sustainable Radiation Shielding Habitat on Mars”, Proceedings of the 69th International Astronautical Congress, Bremen, Germany, October 1-5.

The authors would like to thank Diana Davis, Robin Guenther, David Dymecki, Bruce McEvoy, and Marco Nicotera from Perkins&Will for their input and support.

[10] Papageorgiou, N., (2015). “A Novel Material Turns Space Radiation into Electricity”, École Polytechnique Fédérale de Lausanne, Oct.. See also Paudel, A., (2014). “Energy Harvesting from Solar Wind and Galactic Cosmic Rays”, Journal of Energy Research and Environmental Technology, Vol. 1, No. 1, pp. 33–36.

References [1] Woolf, S.H., (2008). “The Meaning of Translational Medicine and Why It Matters”, JAMA, Vol. 299, No. 2, pp. 211–13.

[11] Conner-Simons, A., (2015). “NASA Gives MIT a Humanoid Robot to Develop Software for Future Space Missions”, MIT News, Retrieved on 6/2/2021 from https://news.mit.edu/2015/nasa-gives-mit-humanoidrobot-future-space-missions-1117#:~:text=NASA%20 announced%20today%20that%20MIT's,missions%20 to%20Mars%20and%20beyond.

[2] Wall, M., (2019). “The Most Extreme Human Spaceflight Records”, Retrieved on 4/6/21 from https:// www.space.com/11337-human-spaceflight-records50th-anniversary.html. [3] Vereen, S., (2019). “NASA Investigates How Dormant Viruses Respond During Spaceflight.” Retrieved on 4/6/21 from https://www.nasa.gov/feature/nasa-investigateshow-dormant-viruses-behave-during-spaceflight. See also Rooney, B., Crucian, B., et al. (2019). “Herpes Virus Reactivation in Astronauts During Spaceflight and Its Application on Earth”, Frontiers in Microbiology, https:// doi.org/10.3389/fmicb.2019.00016.

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03 Outside the Box: An Innovative Approach to Vault Design and the Evolution of the Radiation Oncology Environment Sapna Bhat, RA, LEED AP, sapna.bhat@perkinswill.com Justin Parscale, AIA, LEED AP, justin.parscale@perkinswill.com

Abstract This article investigates the design strategies for enhancing the well-being, comfort, and safety of the patient along with providing spaces for the care givers that streamlines workflow, adapt to technology and care within the premises of radiation oncology treatment. The vault is the core of the radiation oncology treatment process. This study analyzed how the vaults and adjacent program could be reimagined with a goal and purpose to not only improve patient outcomes but also to provide efficiencies within the clinical operational and treatment model. The research method included a case study of the client’s existing cancer facilities and literature reviews followed by design explorations. In addition to the vault design, the owner challenged the design team to incorporate spaces for staff and physicians that aid in collaboration and advancement of the treatment methods through research and technology. The outcome of the final design implementation has been included in this article. Keywords: linear accelerator, cancer, mazeless, radiation, collaborative, and technology

1.0 Introduction Radiation therapy or radiotherapy is one method of cancer treatment where a high dose of radiation is administered to and through a tumor to kill malignant cells and shrink the size of a cancerous tumor. This high dose of radiation is administered fractionally over the course of several weeks with the intent of destroying the DNA of the tumor cells thereby rendering it incapable of multiplying and growing. The radiation can be administered either externally or internally. This study focuses on the external radiation therapy application using photons, where a measured dose of radiation is guided by equipment known as a linear accelerator. The linear accelerators (linac) do not penetrate or touch the patient’s body; however they move around the body and direct the radiation towards the targeted tumor. The treatment is administered in a room often referred to as a vault or a bunker, where the patient is positioned on a treatment table in a predetermined position (as established days earlier by CT simulation).

Each patient’s positioning is unique to their treatment. Multiple patient-positioning devices exist and each aid to restrict the movement of the patient during radiation treatment (beam on process). The total treatment usually lasts for 30 minutes, during this time the patient is alone in the vault while the care team is observing and recording and communicating with the patient from the control area just adjacent to the vault. Due to the high amount of radiation present in the vault, the vault itself must be shielded so that the radiation remains contained within its designated space thereby eliminating the radiation exposure to personnel in the adjoining areas. This requires the vaults to be constructed of either cast-in-place high density concrete, or if budget permits, by using lead blocks of thicknesses determined by a physicist working in conjunction with the design team. In earlier designs, vaults were in the basement of the facility in part to lessen the burden of constructed shielding walls, utilizing the adjacent

Outside the Box

earth’s soil as shielding. This below-grade construction approach compromised the overall efficiency and experience of both the staff and patients. Many of the most recent cancer center designs locate the vault above grade near the main entry level, providing easier wayfinding and more efficiency in terms of patientthroughput, However, challenges remain in terms of efficiency for staff and experience by the patient within the vault itself.

At the onset, the client’s focus was the design of the treatment vault itself. In-depth analysis and understanding of prevalent vault designs, the recognition of existing challenges and pitfalls provided the foundation for the reimagined vault, thus becoming a key marker for the overall success of this project. The design solution had to be innovative, functional, patient/ staff centric, efficient, and flexible to newer technologies and cost-conscious.

While designing a new radiation oncology facility at the University of Texas Southwestern Medical Center (UTSW) in Dallas, Texas, our primary task was to “rethink everything”, including the re-imagining of the vault design and addressing multiple points, including patient experience, staff experience, efficiency, supply chain management and overall safety of the users of the space.

Additionally, since this facility is part of the university system, research and collaboration amongst various cancer care personnel was important. The design team was tasked with the challenge of creating spaces that break down silos and encourage engagement of physicians, nurses, physicists, residents, and the expanded clinical team. Radiation Therapy Treatment Vaults: As mentioned before, radiation therapy vaults are enclosed treatment rooms where a patient diagnosed with specific type of cancer is treated with radiation.

2.0 Methodology

In a traditional vault design, the radiation that is passed from linacs involve primary and secondary scatter of radiation particles (gamma rays). The primary shielding protection is provided by thick concrete or lead walls following the path of travel of the primary beam while the remainder of the vault is comprised of secondary shielding as protection from radiation scatter. Together the primary and secondary concrete or lead shielding form the vault itself. Often a third element is incorporated with the inclusion of an internal wall, forming the maze, as shown in Figure 1.

The research method for this project included a case study of the client’s existing cancer centers, literature reviews followed by in-depth design explorations. Understanding UTSW’s existing workflows, patterns, pit falls and successes within their existing cancer centers helped establish the priorities for the care team in their new facility. Additional literature reviews of vault design, shielding and other construction methodologies aided in the design explorations that were studied and proposed to the client.

3.0 Approach 3.1 Case Study University of Texas Southwestern Medical Center (UTSW) engaged Perkins&Will to design and create a single patient-centric radiation therapy facility by consolidating their clinical and treatment spaces within one building and providing a singular venue to expand their operations. The goal was to create a state-ofthe-art facility which incorporates innovative design concepts and provides spaces that aid in research and collaboration. Figure 1: Entry into a treatment vault through a maze.

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As part of the design process, Perkins&Will analyzed two UTSW’s Radiation Oncology facilities, which were to be consolidated into a single facility—Simmons Radiation Oncology and Moncrief Radiation Oncology. Based on the analysis of the existing facilities, the following were some of the findings for vault design and operations.

Figure 2 indicates the floor plan and the location of the vaults contained within it. Figures 3 and 4 are photographs of the existing conditions, showing that the treatment vaults are cluttered and lack much structured organization and storage. Though not unique to UTSW, there is a natural sense of foreboding for the patient as they traverse the circuitous maze into the treatment zone.

The existing Simmons facility incorporated three mazed vaults, each housing high-energy linear accelerators.

Figure 2: Floor plan of Simmons Radiation Oncology.

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Figure 3: Existing conditions of radiation therapy treatment vault (True Beam equipment) within Simmons Radiation Oncology.

Figure 4: Existing conditions of radiation therapy vault (Vero equipment) within Simmons Radiation Oncology.

Figure 5: Circuitous entry into the linac at Simmons Radiation Oncology.

Figure 6: Control area adjacent to the vaults at Simmons Radiation Oncology.

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At UTSW’s Moncrief Radiation Oncology building, the care and treatment program were distributed between three floors: the basement housing the linac vaults, clinic, first floor housing the main lobby, patient registration and financial counselors, and the second-floor housing CT simulation and treatment planning. At each vault, a maze led the patient into the treatment zone and the

treatment area was cluttered with supplies and storage space was direly needed. The underlying comment from the staff at both these facilities was not just the lack of physical availability of storage space but the lack of ease of finding supplies and immobilization devices designated to each patient.

Figure 7: Floor plan of Moncrief Radiation Oncology.

Outside the Box

Figure 8: Circuitous mazed entry into the treatment vault at Moncrief Radiation Oncology.

Figure 9: View of the vault at Moncrief Radiation Oncology.

An additional vault design challenge was the incorporation of a mobile CT that was to be used during the treatment process. The mobile CT, which is approximately 36”w x 48”d x 60”h required space to park and maneuvered into and within the vault easily without compromising the patient experience or inhibiting staff workflow.

3.2.1 Radiation Protection and Safety Radiation protection and safety are critical factors in designing the vaults. The treatment room shielding should be designed in accordance with suitable recommendations by the physicist performing the shielding calculations in compliance with the shielding regulations imposed by jurisdictions. The room should be large enough to accommodate the specific room’s treatment machine, allowing the full range of motion of the treatment table and patient transport. Access to the radiation treatment room should be clear and should be furnished with a visible signal indicating whether the radiation source is on or off. The door interlocking mechanism to prevent unintended opening during treatment is important, as well as providing a manual release button in case of emergencies. Visual access of the patient is necessary through the cameras within the treatment room which communicate to the control console and care team.1

The goal of UTSW’s Radiation Oncology care management team was to be more efficient and effective through thoughtful workflow planning. The overall design was to create a road map to direct their care team in support of accomplishing their goals. Their current layout created silos amongst the care team, creating a restricted environment to advance research and growth.

3.2 Literature Review Findings from the literature review were grouped into three categories:

Primary and Secondary Beam Shielding: The treatment beam is known as the primary beam and portions of the wall, floor and ceiling providing necessary shielding protection from the primary beam are called primary shielding. The orientation of the linac within the room requires increased concrete thickness to attenuate x-ray

ǌ Radiation protection & safety ǌ Effects of physical space on individuals, and ǌ Cost metrics.

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beams that fall on the shielding surfaces after passing through the patient. Radiation produced when energy is bounced off the patient and other wall/floor ceiling surfaces are called secondary scatter, and secondary shielding provide the necessary protection. Typically, a maze is designed as part of the treatment bunkers to prevent primary and secondary scatter. In instances where photon energies exceed 8.5MV, additional protection is required to attenuate scattered neutrons and is usually achieved by longer maze and shielded door at the end.2

Lead is a dense material and offers excellent shielding against photons. However, lead is not able to support its own weight requiring additional structure and cannot shield against neutrons.

Shielded Doors: Door shielding is complicated because access to the facility necessitates a break in the required continuous shielding. The door must be comprised of a shielding material equivalent to the shielding that would be removed by the door opening. The door may not be placed in the primary barrier. The shielded door can only be located within a secondary shielded wall. If neutrons are present, the door should be comprised of borated polyethylene combined with lead and steel laminate to prevent the scatter from escaping as determined by the physicist. These doors are extremely heavy requiring the use of a motor to operate.3

3.2.2. Effects of Physical Space on Individuals

Steel is not as dense as lead, but it is structurally sound and non-toxic. As mentioned previously, borated polyethylene is perhaps the best neutron shielding material available and is often used to fill the voids around HVAC, wiring, and in doors.3

Research has shown that the general perception of the physical surroundings through the aid of senses impacts the physical wellbeing of an individual.⁴ An individual’s appraisal or perceptions of the event rather than the event itself are predictive of the deleterious effects of stress on health and wellness (Joseph, 2007; Smith, 2007).⁴ There have been studies that indicated high blood pressure levels, increase in heart rate, nausea, and other varied responses to stress.⁴ The responses differ among individuals and are further enhanced if the individual is a patient that is already stressed stress due to the diagnosis of their current health condition. The staff and care takers are also function at higher stress levels directly affecting not only their personal health but can also interfere with the quality of care they provide. With the patient being the most important user of a healthcare facility, it is more important to create spaces and provide opportunities that add to the overall patient experience. Many indignities experienced by patients may be reduced through careful space planning and design. Medical clutter, waste containers, water coolers, coffee makers, personal displays and decorations culminate in a distressing level of visual chaos. Facilities that reduce stress for patients have the same impact on staff, alleviating tension as they care for patients. Putting the patient's experience first may contribute towards initial higher investment, but in return studies have shown that the providers enjoy a strong reputation and exceptional customer loyalty.5

Shielding Materials: Different materials offer protection of varying degrees for shielding applications. Materials are primarily incorporated based upon their effectiveness of shielding properties from different radioactive elements. Additionally, cost and convenience are the driving factors of material incorporation. Construction materials such as concrete, steel and earth are the most used materials for shielding applications. Neutron shielding requires materials that contain hydrogen, while x-ray shielding materials need high mass and atomic number. Materials that cater to one or most of these requirements are concrete, lead, steel, polyethylene, earth, and wood. Concrete is the most incorporated shielding material as it provides protection against x-ray, neutrons while being comparatively less expensive and can be poured in different configurations. There are options to use normal weight concrete or high-density concrete. Higher density concrete uses higher density aggregates and provides better photon attenuation but is not necessarily ideal for neutron shielding. High density concrete provides a design advantage of requiring thinner walls as compared to normal weight concrete.

Careful orchestration of various functions within the space, selection of materials, lighting and other design interventions that helped in reducing stress perceived through the sensorial organs were studied and implemented.

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3.2.3 Cost Metrics

ǌ Patient and staff experience

According to the statistical report by US Oncology, the market share for radiation therapy is expected to grow to 3.9 billion dollars by 2027.6 The key factors that have shaped this trend is the prevalence of cancer along with technological advancements that have made radiation therapy a viable option for treatment. The need to have efficient facilities in treating patients with faster turnarounds becomes more critical in achieving targeted patient volumes. Radiation therapy requires high capital expenditure and is staff and resource-intensive.

ǌ Ease of access to supplies and movement of mobile CT (staff efficiency). The design solution first targeted the area used by the maze. The maze not only caused stress and anxiety to the patient, but it also increased staff’s foot traffic and encouraged unsightly storage of equipment. Elimination of the maze required additional radiation shielding protection at the entry/doorway specifically from photons and neutrons, resulting in a more substantially shielded door. Based on the literature review and discussions with the physicist and the door manufacturer, this door needed to incorporate both borated polyethylene and lead to provide shielding protection. Efficiency of workflow being a key factor in the design process, the incorporation of a bi-parting door in lieu of a slower moving traditional swing-door was integrated to support a quicker patient turn-around. This elimination of the maze resulted in a reduction of cubic yards of concrete by reducing the vault costs. This allowed for the incorporation of a more costly, yet efficient shielded door resulting in costneutral savings. The treatment area within each vault was carefully studied such that the spatial requirements were adequate and accepted by all incorporated linac equipment vendors.

Initial investment costs for radiation oncology are driven by equipment costs, along with the construction materials and methods implemented for shielding. Coupled with that, the operational costs are driven by multiple factors, including the choice of working hours of the facility, supply and demand of consumables, ease of maintenance of the facility as well as equipment, staff retention and satisfaction, and quality of care.

3.3 Evaluating Scenarios Based on the literature reviews, the design team engaged in discussions with the client’s choice of linear accelerator manufacturers to understand the spatial needs, equipment limits and restrictions. To consider different scenarios related to the vault design, the design team hired a cost estimating consultant to understand the initial cost scenarios of using cast in place concrete versus the use of shielded blocks for shielded wall construction. Based on the cost metrics, it did not seem feasible to employ shielded blocks for the case study, but to design around cast in place concrete. The design team explored methods to reduce the volume of concrete used in these vaults and focused on solutions to achieve economies by sharing the shielding between vaults.

As discovered during the literature review, primary shielding is directly related to the orientation of the equipment within the vault and is a continuous belt that goes across walls, ceiling, and flooring. As indicated in Figure 10, the vault with the maze has primary shielding projecting into the vault on opposite sides. In the proposed vault, concrete was used as the main shielding material along with strategic placement of lead blocks. The use of lead blocks embedded within the concrete helped in reducing the wall thickness required at the primary shielding. Since the lead blocks are more expensive, this combination was only applied to the wall where it made a bigger impact with the overall aesthetics of the vault. In this design, the combination of lead and concrete was applied to the wall closest to the patient entry. This enabled the removal of the unsightly projection into the vault as the patient walked in and provided no opportunities for unwanted storage nooks. This wall became the accent wall with quiet elegance and was devoid of clutter and chaos.

4.0 Re-Imagining Vault There were three principal areas that design of the vault focused: ǌ Reduced square footage (especially important as this would bring cost savings due to reduced volume of concrete)

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Figure 10: Square footage comparison between a vault with maze and the vault at UTSW..

Figure 11: Addition of 2 shielded doors at UTSW vault – separating patient and supplies entry points.

Outside the Box

Figure 12: Possible places to store and create clutter within a traditional vault design.

Figure 13: Examples of storage within the vault at Moncrief Radiation Oncology.

Perhaps the most innovative modification to the design of the vault itself is the incorporation of a second shielded door. At UTSW we intentionally minimized the opportunity for in-vault storage, often perceived as clutter by the patient and an inhibitor of efficiency to the care provider. This second door allows for the movement of not only treatment supplies but also the passage of a planned mobile CT. Much like the sterile core supports a surgical suite in the main hospital, the inclusion of what we have deemed a “technical corridor” has been incorporated along the back of a series of vault treatment rooms—accessed by the additional door. The

technical corridor provided ample space for storage to organize regular supplies and vac lock bags, molds, cones, and lenses specific to each patient. The technical corridor also housed blanket warmers, soiled bins closet, and provided a parking space for the mobile CT at either end of the corridor. Space was also allocated for vendorspecific equipment storage. This innovative design has helped reduce clutter within the vault, provided greater and more organized storage space for staff at a lesser cost per area, improved staff efficiency and improved the overall experience of the patient.

Figure 14: Patient (blue) and supply (orange) flow into each vault..

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Figure 15: Daylit patient corridor at UTSW leading to the treatment vaults.

Figure 16: View from the patient corridor into the control console and vault with the technical corridor in the background.

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Figure 17: (Above and Below) Views inside the vaults at UTSW, with the elimination of in-vault storage and clutter.

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Figure 18: View of the technical corridor showing organized storage/supplies and access to daylight.

5.0 Conclusion

By forming Disease Oriented Teams (DOTs), UTSW put the staff and physicians closer to the center of their field of expertise. Each DOT worked in an open office collaborative area, where they were able to exchange information easily amongst their specific teams and amongst other disease teams. This located the physicists, dosimetrists, medical assistants, and residents all working in close relation with one-another and the physicians. Each team had a central open office color-coded zone surrounded by the respective physicians and physicists. Between each of the three zones were informal huddle spaces that encouraged serendipitous collisions amongst peers. These informal collaboration zones pave the way for changing UTSW’s Radiation Oncology team’s way of communicating, educating and sharing information and in delivering care.

The vision set forth by UTSW and their challenge to the design team to "reimagine everything” resulted in the reimagined vault and associated Technical Corridor, resulting in a collaborative work area that engages staff holistically in providing care. This facility was the first to incorporate the two-door vault and Technology Corridor. This NCI-designated comprehensive cancer center at UTSW was completed in 2018. Since the completion of UTSW, Perkins&Will has designed additional cancer centers each incorporating and even improving upon the two-door, maze-less vault and Technology Corridor design albeit on a smaller scale. Some of the improvements included within the vault design are: ǌ Increased floor area by approximately 50 SF to allow for better patient/equipment maneuverability within the vault, specifically at the foot of the couch. ǌ Incorporation of lead block within the primary shielding wall providing less physical interruption of the interior wall surface.

Outside the Box

ǌ Newer technologies have more ceiling mounted equipment which are sensitive to light resulting in careful selection and placement of light fixture within the vaults.

[6] Business Wire, (2020). “ United States Radiation Oncology Market Size, Share & Trends Analysis Report, 2020-2027”, Report, Retrieved on 04/2021 from https:// www.businesswire.com/news/home/20200915005600/ e n / U n i t e d -S t a t e s - Ra d i a t i o n - O n c o l o g y- M a r ket Size -Share -Trends-Analysis-Report-2020-2027--ResearchAndMarkets.com.

Further study is needed to understand the efficiencies of the vault design coupled with the technical corridor on small scale projects.

Acknowledgements The authors would like to acknowledge the entire project team at UT Southwestern for their vision and commitment during the design process. Also, a very special thanks goes to Claire G. Almanza, Director of Marketing, UT Southwestern, Radiation Oncology for her support of this article.

References [1] Podgorsak, E.B., (2005). Radiation Oncology Physics: A Handbook for Teachers and Students, Austria, International Atomic Energy Agency (IAEA) Publication. [2] McMorrow, A., (2019). “Radiation Shielding and Bunker Design”, Biomedical: Scientific and Technical Research, Vol. 18, No. 1, pp. 13322-13324. [3] Darby, K., Mcclanaha, T., Moore, A., Crutcher, C., and Megonigal, M., (2015). "Accelerator Facility Shielding Design", Chancellor’s Honors Program Projects, Report, Retrieved on 04/2021 from https://trace.tennessee.edu/ utk_chanhonoproj/1830https://trace.tennessee.edu/cgi/ viewcontent.cgi?referer=https://www.google.com/&http sredir=1&article=2842&context=utk_chanhonoproj. [4] McCullough, C., (2010). Evidence Based Design for Healthcare Facilities, Indianapolis, IN: Sigma Theta Tau International. [5] Jarvis, J., (2003). “Transforming the Patient Experience in Radiation Therapy”, Radiology Management, Vol. 25, No. 6, pp. 34-36.

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04 COVID-19 Response: Impact of Adaptive Working Behavior on Operating Carbon Roya Rezaee Ph.D., CPHC, LEED AP® BD+C, roya.rezaee@perkinswill.com Cheney Chen, Ph.D., P. Eng., BEMP, CPHD, LEED AP® BD+C, cheney.chen@perkinswill.com Tyrone Marshall, AIA, NOMA, LEED AP® BD+C, tyrone.marshall@perkinswill.com John Haymaker, Ph.D., AIA, LEED AP®, john.haymaker@perkinswill.com

Abstract The COVID-19 public health crisis has affected many aspects of daily living and working behavior, impacting carbon footprint. This research aims to explore adaptive working behavior and its direct and quantifiable environmental impacts. It studies various working and commuting behavior scenarios on energy consumption and the carbon footprint of commuting and building operations. The paper develops a methodology for calculating the impacts of variable working patterns for a North American business. We then conduct two case studies in our own Atlanta and Vancouver studios to model the specific changes in behavior and resulting carbon implications. Considering both buildings and commute patterns, the analysis shows the impact of behavior change on reducing the carbon emission profile of a city, which varies by location. Atlanta can experience more reduction in CO2 emission related to both building operation and transportation due to the higher utility of the electric grid system in the city and heavy reliance on driving cars, compared to Vancouver. The contribution of this work is the methodology for calculating and comparing carbon impacts of different results from home scenarios and the data from two case studies. The work has short-term implications for understanding the impacts of the COVID-19 quarantine and longer-term consequences due to increasing telework demand. Keywords: building energy performance, occupancy, adaptive working behavior, greenhouse gas emission Nomenclatures: Domestic Hot Water (DHW), Department of Energy (DOE), Equipment Power Density (EPD), Energy Use Intensity (EUI), Greenhouse Gas (GHG), Lighting Power Density (LPD), Multi-Unit Residential Building (MURB)

1.0 Introduction Our working and living behavior changed due to the COVID-19 pandemic. Worldwide, people stayed at home and practiced social distancing to contain the spread of the virus. A disease claiming people's lives certainly should not be seen as a way of changing energy and emissions patterns. However, the COVID19 public health crisis has affected many aspects of our typical daily routine, which changed the way we used energy. The behavioral changes could carry over beyond the current COVID-19 pandemic. Not only the

imperative social distancing temporarily transitioned many office workers to work from home, but telework has also been an ongoing demand in recent years.¹ The surge in teleworking raises questions about its impact on different aspects of our life. Environmental impacts associated with buildings' energy performance and commute patterns could lead to some longer-lasting changes in emission profiles of cities. Buildings consume around one-third of total primary energy resources in the U.S., accounting for 30 percent

COVID-19 Response

of CO2 emissions.2 On the other hand, transportation is responsible for nearly one-fourth of the world's CO 2 emissions. The road sector holds the most significant share.3

et al.also showed that lockdown measures directly impacted energy consumption in India.⁶ They reported the positive influence of COVID-19 cases on Indian energy consumption and how it recovered again as the lockdown was relaxed.

This research hypothesizes that adaptive working behavior will have direct and quantifiable energy and carbon impacts on both buildings and the commuting pattern. We aim to explore the impact of working from home, either considered as a short-term scenario due to COVID-19 lockdown or long-term scenario due to potential telework demand, on energy consumption and carbon footprint related to buildings and workrelated travel.

Another set of building energy use metering has been reported by Garcia et al., using the data from advanced metering infrastructure in Manzanilla, Spain.⁷ The study analyzed the consumption behavior and the impact that the crisis has had and showed a 15 percent increase in residential energy consumption during a full lockdown and 7.5 percent during the reopening period. Nonresidential customers had a 38 percent decrease in consumption during the full lockdown and 14.5 percent during the reopening period. The customer metadata in each building type was highly correlated to the restrictions imposed to control the spread of the virus.

1.1 Environmental Impacts of Pandemic in Literature

While the studies provide insight into energy use patterns based on metered data, they fell short on detail that resolves building-level and occupant-level energy consumed. As an alternative, building performance simulation can be used to conduct a detailed predictive study for energy demands during the pandemic. An example of a study using computer simulation is shown by Zhang et al. in Sweden, where three levels of confinement for occupants have been simulated to evaluate the impact of Covid-19 on buildings’ energy demand at a district level.⁸ Compared with the base case, the average delivered electricity demand of the entire district increased 14.3 to 18.7 percent under the three confinement scenarios. However, the mean system energy demands (sum of heating, cooling, and domestic hot water) decreased in a range of 7.1 to 12.0 percent. The two variations nearly canceled each other out, leaving the total energy demand almost unaffected for the location under study.

According to the International Energy Agency (IEA), the current Covid-19 pandemic has had major implications for global economies, energy use, and CO2 emissions.⁴ The first quarter of 2020 showed that countries in complete lockdown were experiencing an average 25 percent decline in energy demand per week and countries in partial lockdown an average 18 percent decline. Daily data collected for 30 countries showed that demand depression depended on the duration and stringency of lockdowns. Global CO2 emissions were over 5 percent lower in Q1 2020 than in Q1 2019. This is mainly due to an 8 percent decline in emissions from coal, 4.5 percent from oil, and 2.3 percent from natural gas. CO2 emissions decreased more than energy demand, as the most carbon-intensive fuels experienced the most significant declines in demand during Q1 2020.⁴ In addition to the IEA report, recent literature has addressed the environmental changes impacted by the pandemic at various scales, from aggregated levels in a country or region to a building level. The studies are predominantly conducted based on the observed data. Geraldi et al., for instance, have monitored the electric energy use of municipal buildings in Florianopolis, Brazil, during the five months lockdown, from March to August 2020.⁵ The observed data provided by City Hall revealed a significant reduction in electricity use, depending on building types. Health centers, administrative buildings, elementary schools, and nursery schools showed a mean decrease of 11.1 , 38.6, 50.3, and 50.4 percent. Aruga

As different studies suggest, there is a high correlation between the pandemic's level of confinement, humans' behavior, and buildings energy consumption. A more detailed analysis of the working behavior and its impact on the operation of the built environment is required.

1.2 Buildings Occupancy and Working Behavior The energy performance of buildings is governed by various parameters, such as their physical

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characteristics, external environment, internal services systems, and the behavior of their occupants.⁹ Human presence and behavior are essential components in the energy performance of a building. According to Robinson, the most complex processes within facilities result from human presence patterns and flows.10 Many studies, such as Emery and Kippenhan11 and Masoso and Grobler,12 acknowledged that the diversity of user behavior has an illustrious effect on energy consumption while keeping other building parameters alike. Clevenger et al. suggested that variant occupant behavior can impact annual energy usage on the order of 75 percent in residential buildings and 150 percent in commercial buildings, with modest variations across climates.13,14 Yun et al. also investigated the influence of human behavior on an office building.15 They showed the 50 percent lighting energy increment due to the change of occupancy presence schedule in observed spaces.

1.3 Modelling Human Behavior in Simulation Tools

The relationship between the behavior of occupants and the operation of buildings is highly complex. Occupants participate in the heat balance of the building through their body heat. Furthermore, occupants' intervention in the control of heating, ventilation, and air conditioning systems and their operation of lighting and appliances (such as cooking) directly affect internal heat loads and ultimately building energy consumption.16 Understanding, quantifying, and modeling the influence of occupant's behavior in buildings energy simulation tools are essential if we are to evaluate the performance of a building.

Both schedules and loads are often modeled in existing simulation practices as simplified predefined fixed profiles.17 These inputs are mostly based on historical data18 or as a discrete “stimulus-behavior relationship”.19 In an office, the existing empirical models of equipment loads tend to be based on statistical algorithms that predict the probability of equipment used from observations of actual case studies. The operational pattern and related occupancy of buildings are different depending on the function of the building and spaces. Consequently, the operational schedules in residential buildings show remarkable differences

The building energy simulation tool is a theoretical representation of the status and operation of a building, designed to replicate the dynamics that govern energy use. Occupant behavior is modeled in simulation tools as Operation Schedules and Loads: ǌ Operation Schedules: By identifying the occupant behaviors in a building as schedules, including occupancy, lighting, equipment, and HVAC schedules, to reflect the usage patterns. Schedules are accounted as hourly data for weekdays, weekends, holidays, and separately for summer and winter design days. ǌ Operation Loads: Quantifying the behavioral information, such as occupancy density, the lighting loads, and equipment loads based on tasks.

Figure 1: Schedule examples of working behavior changes.

COVID-19 Response

2.0 Methodology

compared to commercial buildings. 20 Therefore, knowledge and modeling of such user numbers, actions, and events/schedules are crucial to better predicting and understanding building performance in the time of change.

While most studies rely on the observed data at an aggregated level to evaluate the changes in buildings' energy consumption during the pandemic, this study aims to highlight the role of “working behavior” and its quantifiable impact on the built environment in a controlled experiment. Due to the limitations of isolating a factor in an observational study and the difficulties of gathering the actual energy use data from an individual’s residential building, this study is conducted based on simulations. The computer simulation method has its limitation due to various modeling uncertainties. Still, it is a good candidate in such an exploratory experiment to quantify the changes in loads and schedules and help us predict the consequences of such changes on all categories of energy used in commercial and residential buildings.

When working behavior changes, the activity location, patterns, and schedule during a day changes, as depicted in Figure 1. Additionally, occupants' needs for thermal comfort, lighting, appliance, and other internal services change in both workplaces and residential spaces. Clearly, these changes are not affecting commercial and residential buildings proportionally, nor are they similar in various locations. In addition to the changes in buildings' energy performance, working from home can significantly impact the emissions associated with daily travel made by individuals. This research, therefore, quantifies the changes in working behavior for various scenarios and evaluates the impact on buildings and work-related travels in different urban contexts and climate conditions using computer simulation. The following section presents the methodology for quantifying and modeling adjustable working behavior. Section 3 presents the results and discusses the data for two selected climate locations, followed by a conclusion and future work in section 4.

This study quantifies and models adjustable schedules and load changes derived from adaptive human behavior for various scenarios of working patterns during a week and ultimately over a year. It focuses on two Perkins&Will studios and their employees in Atlanta and Vancouver. The office buildings, as well as residential buildings and commuting networks of all employees, are modeled. The predicted energy use, peak loads, and carbon emission of defined scenarios are compared to assess how the new telework behavior affecting building performances in different climate and urban contexts. Figure 2 presents an overview of the

Figure 2: Overview of research methodology.

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ǌ Equipment: the updated scenario of working in an office does not change the pattern of equipment loads but the amount of their use. As a result, the same equipment schedule in the office is maintained. In contrast, the equipment load decreases proportionally to reflect occupancy reduction. In residential buildings, based on the current assumption of the equipment loads and schedules that are averaged evenly during a week and over a year, the work-from-home triggers an increase in the home-office equipment load, as part of variable miscellaneous electric loads.21

methodology, consisting of five steps, explained in detail in the following sub-sections: ǌ Defining scenarios of adaptive working behavior ǌ Identifying prototype buildings ǌ Running Energy simulations ǌ Online survey for residential typology and commute information ǌ Energy and carbon data integration.

ǌ Lighting: the majority of the lighting load in an office is related to the ambient light, which does not echo the reduced number of employees. On the other hand, the task light decreases proportionally to reflect occupancy changes. Although the more recent office buildings might be equipped with advanced lighting control, we decide to take the ordinary and conservative scenarios in which the ambient lighting is independent of the number of occupants. For residential, an increase in task light is sufficient to reflect the scenario when occupants work from home.

2.1 Defining Scenarios of Adaptive Working Behavior The flexible schedule reflects the changing and adjustable operational schedules for occupancy, lighting, equipment, and HVAC and calculates the corresponding load changes. The modifications in schedules and loads followed different logics in commercial and residential buildings. The updated data is reflected differently in these two types of buildings. This study defines working scenarios as the percentage of employees working within the office, assuming the rest are working from home. The first scenario is the pre-pandemic situation with a 100 percent occupancy working in the office, considered the study's baseline. The rest of the scenarios generated a 10 percent decrement in occupancy until the scenario of an empty office (0 percent occupancy). The occupancy scenarios indicate the offices keep operational with fewer employees present compared to the baseline. Altogether, we study eleven working scenarios and monitor both office and residential buildings' energy performance (Figure 3). For each working scenario, the associated changes in loads and schedules of lighting, equipment, and occupancy for commercial and residential buildings are modified separately. ǌ Occupancy: when fewer employees work in an office, they still follow the same occupancy behavior schedule (e.g., 8am to 5pm) with a decreased number of occupants. While in a residential building, the occupancy number remains the same as the prepandemic situation, but occupancy hours are extended to reflect working from home behavior.

Figure 3: Modified schedules and loads.

COVID-19 Response

2.2 Identifying Prototype Buildings

We asked them to identify their residential types from a list, including low-rise apartments, high-rise apartments, or single-family houses/townhouses/duplex. We asked them to describe their commuting patterns, including distance traveled and mode used for commuting) and to map and report estimated carbon emissions through the https://mapmyemissions.com website.

The study uses the U.S. Department of Energy (DOE) prototype building models developed for commercial and residential buildings to reduce the discrepancies among the individual buildings and facilitate crosscomparisons.22 According to the DOE documentations, the prototypes cover 75 percent of the commercial buildings. Medium to high-rise residential floors are in the United States, which can serve as a valid representation of most structures for study. For the commercial building, the medium-size office model has been chosen to represent the Perkins&Will offices in two locations under study, with a floor area of 53,628 sf and 3 stories. The occupancy is assumed to be 0.0537 people/m2 in a medium-size office, meaning that 268 people occupy the building.

2.4 Energy Simulation Platform We created 88 energy models to explore the 11 occupancy scenarios in two offices and six residential buildings for Atlanta and Vancouver. The models are in idf format, EnergyPlus input files. Energy use, peak loads, and carbon emission were eventually calculated through the EnergyPlus platform. To streamline and semi-automate the simulation process, we have developed scripts in Eppy.23 Eppy is a scripting language for EnergyPlus idf files and EnergyPlus output files written in Python. All the loads and schedule changes for models s are modified by the scripts.

In parallel to modeling an office building with different scenarios, we manage to model different residential types accommodating the 268 employees. They include single-family detached houses, a multi-unit residential building (MURB), low-rise apartments, and multi-family high-rise apartments, as shown in Figure 4. It is essential to recognize the differences associates with various residential types. The proportion of different residential types in locations under investigation would affect the total energy use patterns. Therefore, it is within the research scope, and we investigate it through the online survey discussed in the next section.

2.5 Results Integration Next, we summarized energy and carbon footprint at both building and commute levels. Buildings' operational carbon is calculated at the building's level based on the energy performance results. The commute's carbon emissions, on the other hand, are calculated concerning the number of office occupants and their typical commute types and distances, as collected from the online survey (see Figure 5). Finally, we assess the total energy and carbon footprint of both buildings and the commute system.

2.3 Online Survey: Residential Typology Distributions and Commute Information We designed and distributed an online survey for the employees of the two offices of Vancouver and Atlanta.

Figure 4: DOE Prototype buildings used in the study.

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Figure 5: Energy and carbon data integration.

COVID-19 Response

3.0 Results

literature suggest that Vancouver's single houses' most representative heating system is a gas furnace with a crawl space foundation,24 while in Atlanta is the heat pump system with an unheated basement.25, 26

3.1 Survey Results More than 170 employees in Atlanta and Vancouver offices participated in the online survey, which is about 65 percent of total employees. Based on the data sorted in Table 1, the Atlanta office's employees mostly live in a single-family house, followed by low-rise and high-rise apartments. In Vancouver, employees are primarily residing in high-rise apartments, followed by single houses and low-rise apartments. It is noteworthy that single-family house prototypes are modified and classified to accommodate four different heating systems and four foundation types. The data and

According to the commuting data in Table 2, most employees in Atlanta drive to work, and only about 13 percent of employees commute by walking or biking. Public transportation commuters constituted about 20 percent of workers in the Atlanta office, based on the survey. On the other hand, Vancouver employees most often rely on walking or biking to work, followed by public transportation. Only about 8 percent of employees drive to work regularly. Figure 6 summarizes the differences between the two offices.

Table 1: Residential typology distribution. RESIDENTIAL TYPES & DISTRIBUTION

ATLANTA

VANCOUVER

Low-rise Apartment

18.2%

11.8%

High-rise Apartment

15.9%

52.9%

Single-family House

65.9%

35.3%

Single Family House's Heating System

Heat pump

Gas furnace

Single Family House's Foundation Type

Unheated basement

Crawl space

COMMUTE SYSTEM

ATLANTA

VANCOUVER

Walking/ Biking

13.6%

58.8%

Driving Car

65.9%

8.8%

Public Transportation

20.5%

32.4%

Avg. One-Way Commute Distance (miles)

9.63

4.76

Avg. One-Way Commute Emissions (lb of CO2-e)

5.88

1.25

Table 2: Commute patterns.

Figure 6: Dwelling and commute types in Atlanta vs. Vancouver.

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3.2 EUI and Climate Differences

Climate Zone 4C, which is defined as Mixed Marine with 2000 < HDD18oC ≤ 3000 (3600 < HDD65oF ≤ 5400). Atlanta, on the other hand, is in a cooling driven climate, Climate Zone 3A, which is defined as Warm Humid with 2500 < CDD10oC < 3500 (4500 < CDD50oF ≤ 6300). To better understand energy consumption behavior in each building type and location, the total energy consumption in each building type,including electricity and gas, is listed in Tables 3.1 to 3.4 for Vancouver in section 3.3 and Tables 4.1 to 4.4 for Atlanta in section 3.4, respectively.

The Energy Use Intensity (EUI) data for eleven predefined working scenarios, from 0 to 100 percent office occupancy, have been plotted in Figure 7, crosscomparing commercial and three types of residential buildings. Figure 8 shows the total energy use of the office buildings and the residential units of 268 employees. As depicted, the energy use patterns in the two Perkins&Will office locations behave differently due to the climate difference. Vancouver is in a heating driven climate,

Figure 7: EUI pattern in Atlanta (left) and Vancouver (right).

Figure 8: Energy use breakdown in residential (first bars) & office (second bars) in Atlanta (left) and Vancouver (right).

COVID-19 Response

3.3 Changes in Buildings' Energy Performance in Vancouver

dominated. With a higher occupancy rate in the dwelling space, internal heat gain increases, and heating energy (gas) reduces slightly in MURB-high and low. In Vancouver single-family houses, with higher occupancy rate in the dwelling space, internal heat gain increases and heating energy (gas) reduces. Although more cooling/equipment/ fan energy (electricity) is required, the overall energy would be reduced.

In Vancouver, office buildings with lower occupancy rates will trigger lower cooling, lighting, equipment, fan, pump, and DHW energy use. The only energy increase due to less internal heat gain is heating energy. Overall, energy use in an office building would be reduced significantly. Residential building in Vancouver is still heating energy Table 3.1: Vancouver Office energy use for various occupancy scenarios. 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Heating Energy (kWh) Cooling Energy (kWh) Lighting Energy (kWh) Equipment Energy (kWh) Fan Energy (kWh) Pump Energy (kWh) DHW Energy (kWh)

309,319 13,253 73,881 2,822 12,127 0 0

286,369 17,455 184,232 25,552 16,673 4 18,479

281,508 18,959 187,763 48,408 17,474 8 18,479

274,866 20,711 191,295 71,377 18,303 12 18,479

267,237 22,626 194,827 94,465 19,132 16 18,479

254,663 24,910 198,358 117,681 19,997 20 18,479

239,095 27,518 201,890 141,036 20,931 24 18,900

224,113 30,286 205,421 164,542 21,973 29 20,186

206,851 33,076 208,953 188,213 22,929 33 21,617

189,846 35,907 212,484 212,064 23,990 37 23,073

177,075 38,799 216,016 236,112 25,212 41 24,598

Total Electricity (kWh) Total Gas (kWh)

355,697 55,705

454,546 94,217

473,208 99,391

492,443 102,599

512,152 104,629

532,773 101,335

554,173 95,220

576,546 90,004

596,612 85,059

617,080 80,320

641,960 75,894

Table 3.2: Vancouver MURB-high energy use for various occupancy scenarios. 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Heating Energy (kWh) Cooling Energy (kWh) Lighting Energy (kWh) Equipment Energy (kWh) Fan Energy (kWh) Pump Energy (kWh) Heat Rejection (kWh) DHW Energy (kWh)

371,484 8,070 152,061 325,972 51,862 12,587 387 325,113

368,524 8,272 152,061 326,252 51,733 12,651 396 325,113

365,577 8,480 152,061 326,531 51,606 12,718 406 325,111

362,666 8,694 152,061 326,810 51,480 12,796 416 325,112

359,741 8,911 152,061 327,090 51,351 12,871 426 325,111

356,832 9,136 152,061 327,369 51,224 12,938 436 325,112

353,986 9,364 152,061 327,648 51,096 13,021 446 325,114

351,141 9,600 152,061 327,928 50,958 13,103 457 325,111

348,257 9,840 152,061 328,207 50,830 13,196 468 325,112

345,448 10,087 152,061 328,487 50,715 13,273 479 325,112

342,627 10,339 152,061 328,767 50,606 12,587 491 325,112

Total Electricity (kWh) Total Gas (kWh)

631,057 616,479

630,870 614,132

630,694 611,797

630,543 609,490

630,394 607,168

630,251 604,857

630,144 602,593

630,027 600,332

629,938 598,033

629,872 595,789

629,812 593,538

Table 3.3: Vancouver MURB-low energy use for various occupancy scenarios. 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Heating Energy (kWh) Cooling Energy (kWh) Lighting Energy (kWh) Equipment Energy (kWh) Fan Energy (kWh) DHW Energy (kWh)

101,137 10,638 58,964 143,788 20,105 112,984

100,066 10,797 58,964 143,893 20,129 112,981

99,001 10,956 58,964 143,998 20,153 112,978

97,936 11,117 58,964 144,103 20,175 112,975

96,882 11,280 58,964 144,208 20,198 112,972

95,835 11,443 58,964 144,313 20,218 112,969

94,793 11,608 58,964 144,418 20,241 112,966

93,760 11,774 58,964 144,523 20,263 112,962

92,737 11,942 58,964 144,627 20,285 112,959

91,719 12,111 58,964 144,732 20,308 112,956

90,714 12,280 58,964 144,837 20,331 112,953

Total Electricity (kWh) Total Gas (kWh)

346,479 101,137

346,764 100,066

347,049 99,001

347,334 97,936

347,622 96,882

347,907 95,835

348,196 94,793

348,486 93,760

348,777 92,737

349,072 91,719

349,365 90,714

Table 3.4: Vancouver House energy use for various occupancy scenarios. 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Heating Energy (kWh) Cooling Energy (kWh) Lighting Energy (kWh) Equipment Energy (kWh) Fan Energy (kWh) DHW Energy (kWh)

21,028 607 2,003 7,048 791 6,084

20,970 613 2,003 7,066 794 6,084

20,913 618 2,003 7,084 796 6,084

20,856 624 2,003 7,102 798 6,084

20,800 630 2,003 7,121 800 6,084

20,744 636 2,003 7,139 803 6,084

20,688 642 2,003 7,157 805 6,084

20,632 648 2,003 7,175 807 6,084

20,576 654 2,003 7,194 809 6,084

20,521 660 2,003 7,212 811 6,083

20,466 666 2,003 7,230 813 6,083

Total Electricity (kWh) Total Gas (kWh)

10,448 30,338

10,475 30,281

10,501 30,225

10,527 30,169

10,554 30,114

10,580 30,058

10,606 30,004

10,632 29,949

10,659 29,894

10,685 29,840

10,711 29,786

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3.4 Changes in Buildings' Energy Performance in Atlanta

is heating. Overall, energy use in an office building would be reduced, and the building could be heating rather than cooling-dominated. In Atlanta, the MURB building consumes more heating energy than cooling. More cooling/equipment/fan energy (electricity) is required with a higher occupancy rate in the dwelling space.

In Atlanta, with an increased work-from-home ratio, only the Office EUI is descending. MURB-low and MURBhigh EUI curves are almost flat, and the House EUI curve trends upward. The Atlanta office building with a lower occupancy rate triggers less cooling, lighting, equipment, fan, pump, and DHW energy use. The only significant energy increase due to less internal heat gain

On the other hand, with internal heat gain increases, heating energy (gas) reduces. The trade-offs lead to insignificant energy change with a flat curve. In Atlanta,

Table 4.1: Atlanta office energy use for various occupancy scenarios. 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Heating Energy (kWh) Cooling Energy (kWh) Lighting Energy (kWh) Equipment Energy (kWh) Fan Energy (kWh) Pump Energy (kWh) DHW Energy (kWh)

159,854 84,763 180,864 2,825 15,908 0 0

156,215 91,166 184,392 25,552 17,085 4 18,479

152,392 97,530 187,924 48,408 18,300 8 18,479

147,776 103,870 191,455 71,377 19,565 12 18,479

143,311 110,092 194,987 94,465 20,850 16 18,479

138,306 116,171 198,518 117,681 22,156 20 18,479

127,847 122,239 202,050 141,036 23,431 24 18,613

118,881 128,510 205,581 164,542 24,844 29 19,226

108,495 135,081 209,113 188,213 26,243 33 20,268

100,785 141,960 212,645 212,064 27,795 37 21,467

93,711 148,765 216,176 236,112 29,363 41 22,770

Total Electricity (kWh) Total Gas (kWh)

391,720 52,494

419,056 73,836

446,837 76,203

475,282 77,251

503,980 78,218

532,972 78,359

560,070 75,170

590,064 71,547

619,363 68,083

651,278 65,473

683,718 63,219

Table 4.2: Atlanta MURB-high energy use for various occupancy scenarios. 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Heating Energy (kWh) Cooling Energy (kWh) Lighting Energy (kWh) Equipment Energy (kWh) Fan Energy (kWh) Pump Energy (kWh) Heat Rejection (kWh) DHW Energy (kWh)

248,610 135,913 152,213 325,972 68,253 17,313 6,400 286,269

246,653 136,716 152,213 326,252 68,328 17,374 6,435 286,266

244,737 137,523 152,213 326,531 68,412 17,439 6,470 286,264

242,807 138,331 152,213 326,810 68,496 17,501 6,506 286,264

240,882 139,145 152,213 327,090 68,579 17,568 6,542 286,266

238,975 139,963 152,213 327,369 68,661 17,631 6,578 286,266

237,090 140,787 152,213 327,648 68,741 17,705 6,615 286,266

235,223 141,620 152,213 327,928 68,823 17,779 6,653 286,266

233,355 142,454 152,213 328,207 68,905 17,842 6,691 286,266

231,459 143,306 152,213 328,487 68,975 17,920 6,731 286,266

229,610 144,150 152,213 328,767 69,059 17,313 6,771 286,266

Total Electricity (kWh) Total Gas (kWh)

760,405 480,538

761,264 478,974

762,144 477,446

763,022 475,905

763,913 474,371

764,806 472,850

765,723 471,343

766,654 469,851

767,573 468,361

768,512 466,844

769,474 465,363

Table 4.3: Atlanta MURB-low energy use for various occupancy scenarios. 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Heating Energy (kWh) Cooling Energy (kWh) Lighting Energy (kWh) Equipment Energy (kWh) Fan Energy (kWh) DHW Energy (kWh)

53,638 48,653 59,016 143,788 26,036 100,912

53,124 48,960 59,016 143,893 26,099 100,910

52,616 49,266 59,016 143,998 26,161 100,908

52,097 49,572 59,016 144,103 26,224 100,906

51,600 49,900 59,016 144,208 26,268 100,904

51,102 50,214 59,016 144,313 26,329 100,901

50,613 50,525 59,016 144,418 26,392 100,899

50,123 50,837 59,016 144,523 26,455 100,896

49,643 51,148 59,016 144,627 26,519 100,894

49,162 51,458 59,016 144,732 26,579 100,893

48,685 51,770 59,016 144,837 26,644 100,891

Total Electricity (kWh) Total Gas (kWh)

378,406 53,638

378,878 53,124

379,349 52,616

379,821 52,097

380,295 51,600

380,772 51,102

381,249 50,613

381,727 50,123

382,205 49,643

382,679 49,162

383,159 48,685

Table 4.4: Atlanta House energy use for various occupancy scenarios. 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Heating Energy (kWh) Cooling Energy (kWh) Lighting Energy (kWh) Equipment Energy (kWh) Fan Energy (kWh) DHW Energy (kWh)

5,161 2,837 2,003 7,792 1,133 3,147

5,150 2,850 2,003 7,809 1,135 3,147

5,139 2,863 2,003 7,825 1,137 3,147

5,128 2,876 2,003 7,841 1,139 3,147

5,118 2,889 2,003 7,858 1,140 3,147

5,107 2,902 2,003 7,874 1,142 3,147

5,096 2,915 2,003 7,890 1,144 3,147

5,084 2,929 2,003 7,907 1,144 3,147

5,074 2,943 2,003 7,923 1,146 3,147

5,063 2,956 2,003 7,940 1,148 3,147

5,053 2,969 2,003 7,956 1,149 3,147

Total Electricity (kWh) Total Gas (kWh)

22,073 0

22,093 0

22,114 0

22,134 0

22,154 0

22,175 0

22,196 0

22,215 0

22,236 0

22,256 0

22,278 0

COVID-19 Response

residential building is still heating energy dominated. With a higher occupancy rate in the dwelling space, internal heat gain increases, and heating energy (gas) reduces. Although more cooling/equipment/ fan energy (electricity) is required, the overall energy would be reduced.

computed at the national level in the U.S. and vary by province in Canada. The top two charts in Figure 9 depict the carbon emission changes by varying occupancy scenarios in buildings. As seen, the percentage of GHG emissions associated with buildings in Atlanta and Vancouver are similar (around 5 percent in 0 percent office occupancy); however, the absolute reduction in Atlanta is much higher because of the higher utility of the electric grid system in the region. The electricity in Atlanta comes mainly from coal and natural gas. Only 6 percent comes from renewable sources, while close to 95 percent of electricity in Vancouver and British Columbia is generated from renewable sources such as hydro and biomass.28

3.5 Changes in Buildings & Commute CO 2 Performance This study uses the default fuel analysis approach, which requires only the type and quantity of the fuel to calculate the GHG emissions associated with buildings. Depending on the location, the emissions we consider in the calculation differ and incorporate carbon dioxide, methane, and nitrous oxide emissions to provide a single carbon dioxide equivalent number. This number varies by fuel type and accounts for differences in content and supply across the country. The equivalent factors are regional according to the eGRID sub-regions in the U.S. and provincial levels in Canada for the emission from electricity.27 For the emission from gas, these factors are

Similar to each buildings' operational carbon, GHG emissions associated with commute also show a much higher reduction in Atlanta than in Vancouver due to heavy reliance on driving cars to work. The total emission of buildings operational and commute systems can contribute to a 14 and 18 percent reduction in Atlanta and Vancouver, respectively, if employees continue working from home.

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(a1)

(a2)

(b1)

(b2)

(c1)

(c2)

Figure 9: Carbon reduction amount (kg/year) and percentage related to buildings (a1&a2: on top), commute (b1&b2: in the middle), and the total (c1&c2: bottom) for Atlanta and Vancouver offices.

COVID-19 Response

3.6 Simulation Results Summary

3.7 Simulation Results vs. Actual Energy Use

In Vancouver offices, telework can decrease total energy use, up to 42.7 percent, primarily due to reduced equipment and lighting loads. Working from home can also decrease residential energy use, up to 1.2 percent, mostly due to increased equipment and heating loads. Telework reduces carbon emission in a city, both from buildings operation and commute system. Since the environmental attribute of electric power in Vancouver is already small due to the plants and electric grid systems available in the region, CO2 reduction is not huge. In cities such as Vancouver, with reliance on walking, the decrease in CO2 emission related to transportation is also small. In total, telework for a medium-size office can reduce CO2 emissions by up to 3.3 percent in Vancouver.

Due to the limitations of controlling the experiment in an observational study and the difficulties of gathering the actual energy use data from an individual’s residential building, this study was conducted based on computer modeling and simulation. The authors collected a portion of actual data before and during the pandemic from the office of Vancouver. It consisted of energy consumption and occupancy schedules; an extra analysis has been performed to compare the simulation findings with observed data. Energy use data provided by BCHydro (British Columbia Hydro and Power Authority) were obtained for the Vancouver office from 1st January 2019 until May 2021. We believe that the data covers both pre-pandemic (2019) and pandemic lockdown periods (2020 & 2021). As we expected, energy use reduction is observed during the pandemic when the office is not fully occupied. Figure 10 provides evidence of a clear trend of energy use reduction between pre-pandemic (2019) and pandemic lockdown (both 2020 & 2021). On average, the annual energy use savings is 18 percent (see Table 5), comparing the years 2019 and 2020. We do not have complete consumption data for the year 2021 yet. Still, the energysaving trend has been maintained similarly in the first five months. It is also interesting to observe that in January 2020, as the starting of pandemic lockdown, the energy reduction is not apparent compared to January 2021. This is probably due to the reality that the office occupants just started shifting from work in the office to work from home.

In Atlanta, telework can decrease total energy use in offices, up to 40.5 percent, mostly due to reduced equipment and cooling loads. Working from home can increase residential energy use, up to 0.6 percent, mostly due to increased equipment and heating loads. Telework decreases carbon emission in a city, both from buildings operation and commute system. The environmental attribute of electric power in Atlanta is high due to the plants and electric grid systems available in the region. Therefore reduction of CO2 can have a significant impact on the environment. In cities with heavy reliance on driving personal cars, telework decrease CO2 emissions related to transportation significantly. In total, telework for a medium-size office can reduce CO2 emissions of up to 4.8 percent in Atlanta.

Figure 10: Energy use of Vancouver office in 2019 to 2021.

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Table 5: Comparison between 2019 and 2020 energy consumption of Vancouver office. 2019 (PRE-PANDEMIC) KWH

2020 (PANDEMIC) KWH

SAVINGS

30,349

29,921

30,240

25,611

15%

26,687

24,266

23,586

17,820

24%

22,088

15,691

29%

21,431

15,338

28%

21,589

15,683

27%

19,395

15,620

19%

20,250

15,435

24%

24,795

19,384

22%

24,638

21,884

11%

23,364

19,314

17%

288,411

235,967

18%

Based on the previous simulation findings, we believe the energy reduction is closely related to the occupancy behavior change. Occupancy behavior during the pandemic lockdown has to be tracked to correlate energy use and occupancy. Fortunately, Vancouver studio employees use two systems, Return To Studio (RTS.) and Robin, to self-report their office-desk booking during the pandemic. RTS provides tracking information before Dec 2020. The office decided to use Robin to replace RTS due to the more stringent office selfreporting requirements requested by the local health authority. Occupancy data obtained from RTS and Robin are shown in Figure 11. It indicates that the office's occupancy rate fluctuates between 5 to 30 percent, and the average monthly occupancy rate is around 20

percent. When this 20 percent occupancy rate is applied back to the outputs of the energy simulations (see Figure 7), an energy-saving of 20 percent is expected. It happened when Vancouver office EUI reduced from 144.1kWh/sqm (100 percent office occupancy) down to 114.9kWh/sqm (20 percent office occupancy). The energy savings derived from the simulations (20 percent) and actual utility data (18 percent) are similar. It should be noted that the first month of 2020 may have a higher occupancy rate than during the pandemic and consume slightly more energy. It also indicates the energy simulations can generate reasonable energysaving estimations in the context of a low-rise office building in Vancouver.

COVID-19 Response

Figure 11: Occupancy tracking information of Vancouver office from RTS (top, before Dec 2020) and Robin (bottom, Dec 2020 till now).

4.0 Conclusion

adopting the work-from-home pattern. The changes in CO2 emission associated with buildings in Atlanta are more remarkable because of the higher utility of the electric grid system in the city compared to the renewable sources of electricity in Vancouver.

This study explored the influence of working from home, either as a short-term scheme due to COVID19 lockdown or long-term strategy due to telework demand, on energy consumption and carbon footprint of buildings and commute systems. It defined adaptive working behavior, reflected in buildings' operational schedules and loads, and developed a methodology for calculating and comparing carbon impacts of various scenarios for two locations of Atlanta and Vancouver. The study has shown a considerable influence of adaptive working behavior on the energy demand in office buildings; however, the changes are not equally affecting residential buildings. Telework can decrease total energy use of office spaces up to 40.5 percent in Atlanta and 42.7 percent in Vancouver. The energy performance of offices and all residential buildings of employees collectively can be reduced by 3.2 and 4.5 percent in Atlanta and Vancouver, respectively, if

In general, the CO2 emission reduction related to commuting is higher than buildings operations in both cities. However, Atlanta experiences a much higher decrease than Vancouver due to heavy reliance on driving cars to work. In both buildings and commutes, the behavior change can transform the emission profile of a city at a larger scale, depending on the location and the aviable infrastructures. The research outcome can inform the designers, office managers, and policymakers of the potential energy-saving and low carbon emission measures due to telework. It is entirely possible to develop a framework to propose a future hybrid working policy.

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Figure 12: Atlanta office (left) and Vancouver office (right).

Acknowledgments

A sweet point to achieve reductions of both carbon emissions and office energy is achievable in theory. Still, the research indicates the complexity of interactions among offices, employees' residences, carpooling, and public commute system. Other exchanges occur with first and last-mile travel and beyond the scope of this research in accounting for the differences in emissions. The study is only the first step to understanding the impact of adaptive working behavior on energy and carbon. Limitations are:

The authors would like to express their gratitude to Perkins&Will for the generous research funding with which the innovation incubator project has been completed successfully. The gratitude also extends to the management team and employees of Perkins&Will Vancouver and Atlanta offices for their continuous support and survey participation.

ǌ Only two climate zones are included in the study. For a more comprehensive understanding of climatic impact, the study should be extended to other climate zones.

References [1] Impact of the COVID-19 Pandemic on the Environment (2020). Retrieved on 6/2021 from https://en.wikipedia. org/wiki/Impact_of_the_COVID-19_pandemic_on_the_ environment.

ǌ Only two office buildings are included in the study. Instead of modeling the buildings (see Figure 12), two prototype buildings are used. The Perkins&Will offices have been considered in determining the schedule and load assumptions for simulation. The specific building form, orientation, and envelope details will deviate the energy and carbon performance compared to the prototype office models.

[2] Shaikh, P., Nor, N., Nallagownden, P., Elamvazuthi, I., and Ibrahim, T., (2014). “A Review on Optimized Control Systems for Building Energy and Comfort Management of Smart Sustainable Buildings”, Renewebale and Sustainable Energy Reviews, Vol. 34, pp. 409–429.

ǌ The study is based on energy simulations with assumptions. More accurate results are expected if measurement and verification data are available.

[3] Mathez, A., Manaugh, K., Chakour, V., El-Geneidy, A., and Hatzopoulou, M., (2013). “How Can We Alter Our Carbon Footprint? Estimating GHG Emissions Based on Travel Survey Information”, Transportation, Vol. 40, No. 1, pp. 131-149.

COVID-19 Response

[4] IEA, U. (2020). Global Energy Review 2020. The impacts of the Covid-19 crisis on global energy demand and CO2 emissions.[Online] https://iea.blob.core. windows.net /asset s/7e802f6a-0b30-4714- abb146f21a7a9530/Glob al_Energy_Review_2020.p df [Accessed: 2020-09-10].

Conference on Computing and Decision Making in Civil and Building Engineering, Montreal, Canada, pp. 1-10. [14] Clevenger, C. , Haymaker, J., and Jalili, M., (2014). “Demonstrating the Impact of the Occupant on Building Performance”, Journal of Computing in Civil Engineering, Vol. 28, No. 1, pp. 99-102.

[5] Geraldi, M., Bavaresco, M., Triana, M., Melo, A., and Lamberts, R., (2021). “Addressing the Impact of COVID-19 Lockdown on Energy Use in Municipal Buildings: A Case Study in Florianópolis, Brazil”, Sustainable Cities and Society, Vol. 69, 102823.

[15] Yun, G., Kim, H., and Kim, J., (2012). "Effects of Occupancy and Lighting Use Patterns on Lighting Energy Consumption", Energy and Buildings, Vol. 46, pp. 152-158. [16] Wang, Q., Augenbroe, G., and Kim, J., (2015). “A Framework for Meta-Analysis of the Role of Occupancy Variables in the Energy Use of Commercial Buildings”, Proceedings of the 14th Conference of International Building Performance Simulation Association, Hyderabad, India, pp. 2278-2285.

[6] Aruga, K., Islam, M., and Jannat, A., (2020). “Effects of COVID-19 on Indian Energy Consumption”, Sustainability, Vol. 12, No. 14, 5616. [7] García, S., Parejo, A., Personal, E., Guerrero, J., Biscarri, F., and León, C., (2021). “A Retrospective Analysis of the Impact of the COVID-19 Restrictions on Energy Consumption at a Disaggregated Level”, Applied Energy, Vol. 287, 116547.

[17] Lee, Y. , Yi, Y., and Malkawi, A., (2011). “Simulating Human Behaviour and ts Impact on Energy Uses” Proceedings of the 12th Conference of International Building Performance Simulation Association, Sydney, Australia, pp. 1049-1056.

[8] Zhang, X., Pellegrino, F., Shen, J., Copertaro, B., Huang, P., Saini, P. , and Lovati, M., (2020). “A Preliminary Simulation Study about the Impact of COVID-19 Crisis on Energy Demand of a Building Mix at a District in Sweden”, Applied Energy, Vol. 280, 115954.

[18] Mahdavi, A., (2001). “Simulation-Based Control of Building Systems Operation”, Building and Environment, Vol. 36, No. 6, pp. 789–796. [19] Reinhart, C., (2004). “Lightswitch-2002: A Model for Manual and Automated Control of Electric Lighting and Blinds”, Solar Energy, Vol. 77, pp. 15–28.

[9] Yu, Z., Fung, B., Haghighat, F., Yoshino, H., and Morofsky, E., (2011). “A Systematic Procedure to Study the Influence of Occupant Behavior on Building Energy Consumption”, Energy and Buildings, Vol. 43, pp. 1409–1417.

[20] Ahmed, K., Akhondzada, A., Kurnitski, J., and Olesen, B., (2017). “Occupancy Schedules for Energy Simulation in New prEN16798-1 and ISO/FDIS 17772-1 Standards”, Sustainable Cities and Society, Vol. 35, pp. 134-144.

[10] Page, J., Robinson, D., Morel, N., and Scartezzini, J., (2008). “A Generalised Stochastic Model for the Simulation of Occupant Presence”, Energy and Buildings, Vol. 40, pp. 83-98.

[21] Joshua K., (2012). NIST Technical Note 1765: Prototype Residential Building Designs for Energy and Sustainability Assessment. U.S. Department of Commerce.

[11] Emery, A., and Kippenhan, C., (2006). “A long Term of Residential Home Heating Consumption and the Effect of Occupant Behavior on Homes in the Pacific Northwest Constructed According to Improved Thermal Standards”, Energy, Vol. 31, pp. 677-693.

[22] https://www.energycodes.gov/development/ commercial/prototype_models. [23] https://eppy.readthedocs.io/en/latest/index.html. [24] h t t p s : / /w w w.fo r t i s b c .c o m /n e w s e v e n t s /s t o r i e s - a n d - n e w s - f r o m - f o r t i s b c / the-costly-truth-about-your-old-furnace.

[12] Masoso, O., and Grobler, L., (2010). “The Dark Side of Occupants' Behaviour on Building Energy Use”, Energy and Buildings, Vol. 42, pp. 173–177.

[2 5] ht t p s : / /w w w.e n e rg yc o d e s .g ov/a d o pt i o n / states/georgia.

[13] Clevenger, C., and Haymaker, J., (2006). “The Impact of the Building Occupant on Energy Modeling Simulations”, Proceedings of the Joint International

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[26] Kaufman, N., Sandalow, D., Rossi di Schio, C., and Higdon, J., (2019). “Decarbonizing Space Heating with Air Source Heat Pumps”, Report, Retrieved on 6/2021 from https://www. e n e r g y p o l i c y. c o l u m b i a . e d u /r e s e a r c h /r e p o r t / decarbonizing-space-heating-air-source-heat-pumps. [27] U.S. EPA's Emissions & Generation Resource Integrated Database (eGRID). eGRID2018 (released 1/28/2020) contains the complete release of year 2018 data. https:// www.epa.gov/energy/egrid. [28] h t t p s : / / w w w 2 . g o v. b c . c a /g o v /c o n t e n t / industry/electricity-alternative-energy/electricity/ residential-electricity.

Perspective

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05 Book Review: Research Methods for the Architectural Profession, by Ajla Aksamija David Green, AIA, LEED AP® BD+C david.green@perkinswill.com

Research in the profession of Architecture has been an ill-defined endeavor for decades. During the 1980’s, research was by and large under the purview of academic institutions, and it was primarily focused on issues that were perceived by professionals as having questionable relevance to their work. Through the end of the millennium firms, with few notable exceptions, were not interested in research beyond that which supported a particular project, and there was very little effort to track and evaluate project performance beyond project completion. This started to change in the early part of the new millennium, and today the discussion around research in the profession has increased significantly. However, research itself, how it is practiced in the profession, continues to be a very challenging effort on the part of both the academy and the profession. There is certainly an increase in aspiration but not necessarily a commensurate gain in actual research produced. First Published: 2021 By: Routledge, New York

This is the point at which many people who are involved in research efforts in Architecture will point to a number of examples of significant and rigorous research projects as a counterpoint to these assertions. It is true that research has expanded, but it is not close to being as pervasive and fundamental to Architecture as it is to other professions that have similarly significant impacts on our environment, health and overall well-being. Architects, and designers in general, are taught to solve problems through nuanced and creative processes, and this can be in conflict with the seemingly rigid and structured protocols necessary in basic research based on scientific principles.

Book Review

Aksamija, with her new book, ‘Research Methods for the Architectural Profession’, addresses these issues with clarity and directness. The book is structured and written with the precision of a well-executed research project, and it delivers a rich, easily understood narrative that outlines the issues surrounding research in the profession with objective dispassion, while also delivering an immanently readable book. I am reminded of the writings of Atul Gawande, particularly ‘The Checklist Manifesto’, his excellent investigation into reducing errors, originally in medical procedures, to reduce risk of infection. Aksamija does something similar in her book, addressing the difficulties in Architecture by clearly articulating what research is, how it relates to the design process, and why we should do it. In fact, this is the structure of the Introduction chapter of the book, which clearly lays out these issues and gives the reader a strong point of departure to move through the rest of the book, which addresses research processes, research methodologies and integration of research into the practice. It is supported by case studies throughout the book, with a strong series of studies comprising the final chapter.

of process and methods. The value of this approach is that everyone can quickly glean the key elements that drive research, facilitating a more uniform platform for the broader discussions around the topic, while also providing a very specific roadmap for those involved in the research itself. This last point, the clearly outlined chapters on process and methodology, is the core of the book. These chapters should be used as the framing device for all firms as they discuss how they will approach and engage in research. As each firm moves through this process, identifying what and how research is incorporated into their efforts, these chapters and sections also offer a very specific roadmap for executing the research projects themselves. From defining the scope and objectives of the research to the application of the results, Aksamija delivers the most cogent outline and comprehensive explanation of these issues that I have seen. If you are truly interested in expanding the value of the profession through rigorous research, then this book is the perfect orientation (or for some, re-orientation) to the endeavor. This is not a book that one reads once and then moves on. It is a reference for research; a book that is used constantly to guide and focus the work of research in the profession. It will be invaluable to those in the trenches, as well as those driving policy and direction for firms, and for the overall profession. My copy only arrived a couple of weeks ago, but it is already dog-eared, filled with notes and comments, and sections highlighted that answer questions I have had for years. If we are truly interested in solving the challenges we are facing, then this book is essential to that aspiration.

Aksamija’s facility with the topic of research is evident in her writing, however the key strength of the work is its dispassionate attitude towards the topic. She is not drawn into the broader, esoteric discussion about the relevance of research in the profession and the disconnect between the academy and the profession, rather she takes it as a given that research has value to the profession. This is exemplified by the first sentence of section 2 of chapter 1, where she simply states the obvious need to engage in research in Architecture. It is an axiomatic statement and should not be open to dispute. By addressing this issue in such a straightforward manner, she is able to focus the book on the ‘what’ and ‘how’ of research. This allows her to unravel complex issues, explaining them with lucidity to anyone interested in research in Architecture (which, of course, should be everyone associated with the design and construction of buildings, parks, streets, cities, etc.).

After years of broadly unfulfilled ambition, it is encouraging to see this book as the standard with which the profession can finally fulfill that long simmering ambition.

The discussion is supported with clear, simple diagrams that support the narrative and give critical roadmaps to successful research efforts. This is further reinforced by the structure of the book itself, moving from the broader overviews to more highly detailed descriptions

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Peer Reviewers Abul Abdullah Intertek Dr. Ajla Aksamija University of Massachusetts Amherst/ Perkins&Will Dr. Pravin Bhiwapurkar University of Cincinnati Dr. Bowman K. Davis Kennesaw State University (Emeritus) Dr. Ladan Ghobad ENERlite Consulting Ming Hu University of Maryland Kalpana Kuttaiah Perkins&Will John Neary HOK

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Authors 01

Joshua Robinson Josh is a designer at Perkins&Will in our Atlanta studio. He specializes in hospitals and medical facilities. On a day-today basis, he exercises creative judgment and assists senior associates and principals with project pursuits while also helping to ensure our process and design approach is client and patient centered.

Pegah Zamani Dr. Zamani is an academic researcher, and co-founder of Eco-Morphology Lab—an interdisciplinary lab focused on sustainable, equitable design and public health. She holds a Ph.D. in Design Morphology from Georgia Tech and presently is an Associate Professor at the Kennesaw State University, Department of Architecture. Pegah has taught, published, and exhibited nationally and internationally.

Julio Brenes Julio works at the Perkins&Will Atlanta studio and is involved in our Healthcare, Urban, and Transport projects. His work ranges from concept design to technical coordination. He enjoys the creative architectural process, especially when it involves hand drawings to communicate the design intent and ideas.

Julia Cheng Julia is a designer at Perkins&Will's Atlanta studio. She has a background in architecture, interior design and architectural history. She has been involved in large healthcare projects that has had her working on design, coordination, and documentation tasks. Her drive is to enhance life through design.

Kalpana Kuttaiah

Kalpana is the research knowledge manager for the health practice at Perkins&Will. She has a long career and background in architecture, design and research informed by myriad cultural experiences. With a passion for design and innovation informed by critical inquiry and thinking, she promotes ideas and research that culminate in publications and interdisciplinary exchanges.

Lauren Neefe

Dr. Neefe is a writer and editor for the Atlanta and North Carolina studios of Perkins&Will. She advocates for writing and storytelling as drivers, not just description, of the design process across practice areas. She specializes in researching and crafting site-context and project narratives as well as history exhibits in educational environments. Her favorite projects reimagine public space, and she is always looking for ways to bring audio storytelling into conversations about design. Sapna Bhat

Sapna is an architect in the Dallas studio of Perkins&Will. Her experience spans a wide variety of healthcare projects. Sapna’s focus has been on Oncology Centers. She believes in empathetic architecture and is passionate about creating spaces that not only enriches the experience of this unique group of users but also provides positive outcomes.

Justin Parscale Justin is an architect in the Dallas studio of Perkins&Will. While designing and planning both greenfield and complex renovation hospitals, Justin developed a particular interest in Oncology and specifically Radiation Oncology planning. He is constantly seeking design methods that improve the environment and experience and outcomes for Radiation Oncology patients and caregivers.

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Authors 04

Roya Rezaee Dr. Rezaee is the co-director of Energy Lab at Perkins&Will. She works at the nexus of building performance simulation, parametric modeling, BIM, computational design, data analysis, and risk and uncertainty assessment in the field of building simulation. Her work has been focused on developing a methodology and platform to help designers make an informative decision at the early stages of design.

Cheney Chen Dr. Chen is a senior sustainable building and energy engineer with Perkins&Will Vancouver office. Drawing upon his architectural and building science backgrounds, Cheney excels at communicating effectively across the disciplines to optimize project success.

Tyrone Marshall Tyrone is a senior researcher & computational designer at the Perkins&Will Atlanta studio and works directly with project teams for their strategies to address architectural performance design, including the planning, development, implementation of new processes from our research program.

John Haymaker

Dr. Haymaker is the director of research at Perkins&Will. He also oversees Perkins&Will's Innovation Incubator, the firm's practice-based knowledge centers, and project-based integrated research. John also leads Perkins&Will's AREA Research, a non-profit organization that conducts research related to the built environment for public benefit.

David Green David is an architect in Perkins&Will's Charlotte studio. He strives for innovation and enjoys resolving complex urban issues. His project are aspirational but achievable—his realization of seemingly impossible challenges have helped shape cities in a number of different places. David sets progressive standards that create new global benchmarks— from individual sustainable buildings to national-scale plans.

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The 24th Issue of the Perkins&Will Research Journal

Articles inside

Impact of Adaptive Working Behavior on Operating Carbon

An Innovative Approach to Vault Design and the Evolution of the Radiation Oncology Environment

Research Methods for the Architectural Profession

Editorial

Journal Overview

Therapeutic Community as a Translational Laboratory